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Infectious Disease > Sepsis > Flashcards

Sepsis Flashcards

1
Q

In which gender does sepsis more commonly affect?

A

Males

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2
Q

What is the general trend of sepsis diagnosis? Why?

A

Going up

Patients are living longer

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3
Q

What is SIRS?

A

Systemic inflammatory response syndrome

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4
Q

What are the four criteria that define SIRS?

A
  1. Temp more than 101.4 F or less than 96.8 F
  2. HR more than 90
  3. RR more than 20 or PaCO2 less than 32
  4. WBC more than 12 or less than 4
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5
Q

What is the range of temperatures that define SIRS?

A

Less than 96.8 or more than 101.4

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6
Q

What is the HR that defines SIRS?

A

More than 90 bpm

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7
Q

What is the RR that defines SIRS?

A

more than 20 breaths per minute

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8
Q

What is the PaCO2 that Defines SIRS?

A

Less than 32 mmHg

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9
Q

What is the WBC count that defines SIRS?

A

More than 12, less than 4, or bandemia of more than 10%

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10
Q

How many criteria of the SIRS definition must be met to diagnose SIRS?

A

2 of the 4 AND suspected or identified infection

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11
Q

What are the BP ranges that define hemodynamic compromise?

A

Less than 90 SBP
MAP less than 70
SBP decrease by 40

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12
Q

What lab value is used to assess for general organ dysfunction?

A

Lactate

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13
Q

What is the UOP that defines organ dysfunction?

A

Less than 0.5 mg/kg/hr for 2 hours despite adequate hydration

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14
Q

What are the pulmonary criteria for end organ dysfunction?

A

PaO2/FiO2 less than 250 or 200 in absence/presence of PNA respectively

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15
Q

What bili level indicates liver dysfunction?

A

More than 4

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16
Q

What CrCl level indicates renal dysfunction?

A

More than 2

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17
Q

What is the definition of septic shock?

A

Sepsis + hypotension despite resuscitation measures

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18
Q

What is the sepsis continuum?

A

SIRS
Sepsis
Severe sepsis
Septic shock

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19
Q

What are the two major pathophysiological factors that affect sepsis prognosis/severity?

A
  1. Pathogen features

2. Host features

20
Q

What causes the decreases systemic vascular resistance in sepsis?

A

Proinflammatory cytokines

21
Q

What is distributive shock?

A

Peripheral vasodilation causes an acute drop in BP, leading to reflex tachycardia

22
Q

What are the three most common etiologies of septic shock?

A

UTIs
Pneumonia
GI infx

23
Q

What are the ssx of sepsis (mnemonic of SEPSIS)?

A 
Shivering
Extreme pain
Pale
Sleepy
Impending doom
SOB
24
Q

Lymphedema from working in the garden = ?

A

Sporotrichosis

25
Q

Bowel ruptures should be treated for what type of bacteria?

A

Gram negative anaerobes

26
Q

What is one of the first organs to be affected in septic shock? What lab value is used to evaluate this?

A

Kidneys

CrCl

27
Q

What does a HCO3 level tell you?

A

Acidosis/alkalosis

28
Q

Why get coags for sepsis?

A

Determine if DIC is present

29
Q

What is the best timeframe for the delivery of abx for a septic pts?

A

Within 1 hour

30
Q

What are the most common infectious agents that mediate sepsis? (5)

A 
Staph aureus
Strep Pneumoniae
E. Coli
Klebsiella
Pseudomonas
31
Q

What percent of blood cultures are positive in septic patients?

A

only 1/3

32
Q

What is the lab value that can be used to evaluate for rhabdomyolysis?

A

CK

33
Q

What is the equation for MAP during sepsis?

A

SABP + 2xDABP / 3

65 mmHg

34
Q

True or false: with appropriate cuff measurements, BP readings can be as accurate as central line measurements

A

True

35
Q

What type of IVFs are the initial treatment of choice for sepsis? HOw much should be administered?

A

Crystalloids

30 mL/kg

36
Q

How long should IVFs be run with Sepsis?

A

As long as showing continuing ssx of improvement

37
Q

Why start a central line for sepsis?

A

If giving pressors or large boluses of meds.

However, PICCs can get IVFs nearly as quickly

38
Q

What happens if MAP is still not at the goal after 30 ml/kg of IVFs?

A

Diagnose septic shock

39
Q

What is the best pressor?

A

NE

40
Q

What, besides NE, can be used for pressors?

A

Epi
Vasopressin
Dopamine
Phenylephrine

41
Q

True or false: vasopressin is a first line pressor

A

False– do not use it first

42
Q

Which type of abx therapy is better for gram negatives: mono or combination therapy?

A

Combo

43
Q

How important is it to ensure that lactate levels fall with treatment of sepsis?

A

Very–tells you how effective resuscitation measures are

44
Q

What are the four things to be completed within 3 hours of presentation of sepsis?

A
  1. Lactate levels
  2. Blood cultures
  3. Abx
  4. IVF (30ml/kg)
45
Q

What are the three things to be completed within 6 hours of presentation of sepsis?

A
  1. Apply pressors if needed
  2. Assess tissue perfusion
  3. Remeasure lactate
46
Q

True or false: a physician’s assessment is equivalent to obtaining additional labs for assessing for adequate tissue perfusion

A

True

Infectious Disease (18 decks)

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