Sepsis

Question 1

Systemic Inflammatory Response Syndrome

Answer 1

2 of these
Temp >38, 
HR > 90
RR >20
WBC > 12k, 10% bands

Question 2

Sepsis flow chart

Answer 2

SIRS+ infection = sepsis,
+ Organ Dysfxn of low BP less than 90 = severe sepsis
+ hypoTN despite resuscitation = shock
+ 2 or more organ dysfxn = multiple organ dysfxn syndrome

Question 3

Sepsis Pathogenesis

Answer 3

Pathogen –> immune cells –> release pro-inflammatory cytokines -> PM cells arrive -> vasodilation and vascular permeability -> TF expressed -> micro-coagulation uses up clotting factors
Now know that T & B cells get depleted as well

Question 4

Diphtheria

Answer 4

Diphtheritic membrane - like candida + swollen neck
Cutaneous lesions
Seems to stick around even with vaccinations
Gram positive rod
On agar looks like Chinese calligraphy
Toxoid vaccine

Question 5

Diphtheria toxin

Answer 5

Attacks heart, periph nerves, kidneys
One molecule toxin can kill one cell
Inhibits protein synth by modifying EF-2
Carried on bacteriophage and only expressed in low iron environments

Question 6

Pertussis

Answer 6

whooping cough - cough so much can’t catch their breath
Complication = hemorrhage
Aerobic gram neg. coccobaccilli
Catarrhal stage - 7-10 days, cold-like syptoms
Paroxysmal - 1-6 wks, rapid coughing, whoop, cyanosis, high lymphocytes
Convalence - 1-7 days, recovery

Question 7

Meningitis

Answer 7

Strep. pneumo > Neisseria men&raquo_space; H. flu
All encapsulated organisms - often people become colonized in upper respiratory before outbreak
Uncapsulated can cause, but usually due to head trauma

Question 8

H. flu

Answer 8

Gram neg, coccobacillus
Encapsulated
Grows on chocolate agar & with XV factor (heme & NAD)
Can grow near Staph on blood agar
H. ducreyi only around X and paraflu only around V
Capsule serotypes a-f - vaccine only against b

Question 9

N. meningitidis

Answer 9

Grows well on blood agar
Gram neg. diplococcus
Encapsulated
Type A serogroup most associated
Vaccines for all types

Question 10

Otitis Media

Answer 10

S. pneumoniae > 50%

Question 11

Strep pnemo vaccines

Answer 11

Prevnar - conjugated form 13 capsule proteins for all peopole
Pneumovax - was only for older people because only shown to be effective in preventing meningitis in adults