sepsis Flashcards
What are the warning signs of sepsis
Slurred speech or confusion Extreme shivering or muscle pain Passing no urine (in a day) Severe breathlessness "I feel like I might die" Skin mottled or discoloured
Why can it be difficult to spot?
sometimes, it can be very obvious that a patient has low bp and high temperature.
And patients might breathe rapidly and have a racing pulse, for example.
-But early on, all these symptoms can be MISTAKEN for influenza or other infections.
why is the diagnosis of sepsis is a huge worry for GPs?
initial symptoms can be very similar to common viral illnesses
candida is larger than a bacteria…T/F? why
yes, its is a yeast
what is bacteraemia? septicaemia?
- presence of bacteria in the blood
- outdates clinical term meaning generalised sepsis
what urgent investigation can u perform? and why?
- full blood count> check for neutrophils
- blood sugar
- coagulation clotting factors
- liver function
- CRP > marker of inflammation
- blood gases
- CSF
- urea & electrolytes> septic ppl can have renal failure
- blood cultures> confirm and identify the bacteria causing the infection.
- imaging> look for abdominol X-ray or CT to look for pathology related Tumor.
life threatening complication?
- kidney acute injury (renal failure)
- hypotension irreversible
- inter cranial pressure
- respiratory failure
- necrosis of digits/hands/feet
explain how sepsis leads to a reduction in blood pressure? & explain how the patient becomes tachycardiac?
inflammatory response causes cytokines to be released and cause vasodilatation.
endotoxins (LPS) r the most potent stimulators of cytokine release.
Tachycardia occurs due to body compensating. but this compensation own be effective enough to solve the problem.
Which immune cell recognises the bacterial pathogen?
Which component of the bacteria is most important in triggering a reaction from this immune cell?
n
Name some of the molecules (mediators) produced by this immune cell in response to the pathogen
n
Where is CRP produced (i.e. which organ)?
What triggers this organ to produce CRP and other proteins?
How quickly is CRP produced?
Why is CRP measurement useful in clinical practice?
What is the function of CRP?
Can the CRP level help to identify the bacteria or the correct treatment?
- liver
- when inflammation is high, macrophages r present in high amounts in the blood!> they produce CYTOKINES (iL-6 & il-1B) that will go to the liver & tell hepatocytes to make more CRP (making it a marker of inflammation)
- a few HOURS to be produced and measured in blood
- if raised, useful indicator that inflammation is there (but not specific)
***it binds to phophocoline expressed on the surface of dead bacterial cells and some bacteria, this activates the complement system promoting phagocytosis by macrophages.
The production of CRP is part of the “Acute Phase Response”. Name one other important feature of the acute phase response (also triggered by the substances produced by the immune cell).
n
What is sepsis? what is a septic shock?
- Serious life-threatening response to infection
- persisting hypotension
Why should u be careful when u want to consider doing a lumbar puncture to a septic patient?
a septic patient could have a raised intracranial pressure, if we take a CSF in lumbar region, & reduce the pressure there, this might allow the brain to suck down & the base of the brain can be stuck at the top of the spinal cord
Why can some patient represent with high lactate during infection? how will they appear clinically?
Body starts to undergo metabolism anerobically, and this produces lactic acid, which can cause lactic acidosis.
-hyperventilate to release excess Co2
