sepsis

Question 1

what is colonisation

Answer 1

presence of a microbe in the human body without an inflammatory response

Question 2

what is infection

Answer 2

inflammation due to a microbe

Question 3

what is bacteraemia

Answer 3

presence of viable bacteria in the blood

Question 4

what is sepsis

Answer 4

life-threatening organ dysfunction caused by a dysregulated host response to infection

Question 5

what is septic shock

Answer 5

subset of sepsis with circulatory and cellular/metabolic dysfunction associated with higher risk of mortality

Question 6

what are the symptoms defining septic shock

Answer 6

sepsis with adequate volume resuscitation and either:

persistent hypotension
lactate > or equal to 2

Question 7

what is a pathogen

Answer 7

ANY microorganism that has the potential to cause disease

Question 8

what is virulence

Answer 8

the likelihood of the pathogen causing disease

Question 9

what is sepsis 6

Answer 9

GIVE:

• oxygen (if <94%)
• IV antibiotics
• IV fluids

TAKE

• blood cultures (± sputum ± urine)
• lactate
• urine output

Question 10

what BP should you aim for in sepsis what should you do if this is not reached

Answer 10

MAP>65

add vasopressor if not reached (e.g. noradrenaline)

Question 11

how much fluids should be given in sepsis 6

Answer 11

250-500mls over 15mins

aim for 20ml/kg over 1st 3 hrs

Question 12

give examples of gram positive cocci

Answer 12

staph
strep
enteroccoci

Question 13

give examples of gram positive bacilli

Answer 13

listeria
clostridia
corynebacterium

Question 14

give examples of staph organisms

Answer 14

staph aureus
MRSA
staph epidermis

Question 15

what is the treatment of staph aureus in sepsis

Answer 15

IV flucox

IV vancomycin if allergic

Question 16

is streptococci found in clusters or chains

Answer 16

chains

STRep = STRipes

Question 17

what are the 3 types of strep (growth on blood)

Answer 17

alpha haemolytic
beta haemolytic
gamma haemolytic

Question 18

what colour is alpha haemolytic strep, what type of lysis is this

Answer 18

green = partial lysis

Question 19

what colour is beta haemolytic strep, what type of lysis is this

Answer 19

gold = complete lysis

Question 20

what colour is gamma haemolytic strep, what type of lysis is this

Answer 20

clear = no lysis

Question 21

give examples of an organism which is alpha haemolytic

Answer 21

strep pneumoniae

strep viridans

Question 22

give examples of an organism which is beta haemolytic

Answer 22

strep pyogenes

Question 23

give examples of an organism which is gamma haemolytic

Answer 23

Enterococci faecalis

Question 24

what is the treatment of Enterococci faecalis

Answer 24

IV amoxicillin
step down to oral co-tromoxazole
if allergic use vancomycin

Question 25

what is the treatment of MRSA

Answer 25

IV vancomycin

Question 26

how an you tell the difference between staph aureus and staph epidermis

Answer 26

staph aureus = +ve coagulase test

staph epidermis = -ve coagulase test

Question 27

describe the cell wall of a gram NEGATIVE bacteria

Answer 27

double membrane containing phospholipids and lipopolysaccharides

Question 28

give examples of gram negative cocci

Answer 28

haemophilus influenza

neisseria

Question 29

what is special about neisseria

Answer 29

it is diplococci

Question 30

what is the treatment of haemophilus influenza

Answer 30

amoxicillin

doxycycline if allergic

Question 31

what does haemophilus influenza require to grow

Answer 31

chocolate agar media

Question 32

give examples of gram negative bacilli

Answer 32

pseudomonas
E.coli (coliform)
klebsiella (coliform)

Question 33

describe E.coli

Answer 33

gram negative rod

Question 34

describe Klebsiella

Answer 34

gram negative rod