Sepsis Flashcards

1
Q

sepsis temprana

A

<3 dias
contagio vertical
neumonia como presentacion mas comun

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2
Q

sepsis tardia

A

> 3 dias
contagio horizontal
bacteremia y meningitis es lo mas comun

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3
Q

estandar de oro sepsis neonatal

A

cultivo

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4
Q

germen mas comun en sepsis neonatal

A

Stafilococo coagulasa negativo 50%

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5
Q

patogenesis sepsis neonatal temprana

A
  1. deglucion LA infectado en utero

2. colonizacion piel tras nacimiento

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6
Q

clinica corioamnioitis

A

fiebre materna >38 C + 2 criterios:

  1. leucos > 15,000
  2. FC materna: >100
  3. FC fetal; >160
  4. sensibilidad uterina
  5. LA fetido
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7
Q

patogenos mas frecuentes en sepsis neonatal temprana

A

ureoplasma

mycoplasma

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8
Q

factores de riesgo sepsis neonatal temprana

A
parto prematuro
colonizacion materna SGB
RPM >18 hrs
signos y sintomas de infeccion intraamniotica
mujer blanca
pobreza
genero masculino fetal
apgar bajo
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9
Q

cultivo de sangre en sepsis neonatal temprana

A

75% de los que tienen sepsis resulta positivo

tomar muestra de vena umbilical

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10
Q

cultivo de aspirado traqueal sepsis neonatal temprana

A

valor si se toma muestra antes de intubar

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11
Q

indicaciones de puncion lumbar en sepsis neonatal temprana

A

hemocultivo positivo
curso clinico o de laboratorio que sugiera sepsis neonatal tardia
RN que empeora a pesar de tx

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12
Q

PCR en sepsis neonatal temprana

A

aumenta 6 a 8 h pico a las 24 h
aumenta sensibilidad si se toma 6-12 h tras nacimiento
2 PCR normales 8 a 24 y otra >24 negativas descartan sepsis

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13
Q

procalcitonina en sepsis neonatal temprana

A

incrementa a las 2 h, pico a las 12 h

normalizacion a 2 a 3 dias

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14
Q

manejo sepsis neonatal temprana

A

ampicilina/aminoglucosido

ampicilina/cefotaxima (solo en meningitis gram negativo)

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15
Q

prevencion sepsis neonatal temprana EGB

A

penicilina, ampicilina, cefazolina 4 h antes del parto

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16
Q

antimicrobianos intraparto

A

cultivo positivo para EGB

colinizacion materna desconocida en < de 37 SDG pero con RPM > 18 h o temperatura > 39 C