Sepsis Flashcards

1
Q

How is sepsis diagnosed?

A

NEWS >5 + infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is septic shock?

A

Continued deterioration and hypotension despite adequate fluid resuscitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the treatment for sepsis and within what timeframe must this be delivered?

A

Within 1 hour: BUFALO

Blood cultures (+ other cultures - sputum, urine, stool, joint aspirate)
Urine output (use fluid balance chart >0.5ml/kg/hr)
Fluids IV (30ml/kg/hr over 3 hours saline)
Antibiotics (based upon clinical picture)
Lactate measurement (concern if >4mmol/L, remeasure within 2 house (sign of hypo perfusion))
Oxygen (high flow through non-rebreather)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What should be given if patient remains hypotensive after BUFALO?

A

Vasopressors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What colour are gram +ve and gram -ve bacteria on staining?

A
Positive = Purple
Negative = piNk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What strains of streptococcus undergo beta haemolysis?

A
Strep pyogenes (GAS)
Enterococcus faecalis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which strains of strep undergo alpha haemolysis??

A

Strep pneumoniae, Strep viridans,

Ent. faecalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What drug is used to treat streptococcal infections?

A

Amoxicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What drug is used to treat staph aureus infection?

A

Flucloxacillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What drug is used for Staph epidermidis infection and what infection is it indicated in?

A
Vancomycin 
Endocarditis (prosthetic valve)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What treatment is used for Ent faecalis and what infections is it indicated in?

A

UTI, GI infections

Amox + Gent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What infections is Strep pneumoniae indicated in?

A

Pneumonia, otitis media, meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is used as an alternative if the patient is allergic to penicillin?

A

Doxycycline or vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What bacteria is indicated in throat infections (tonsillitis)?

A

Strep pyogenes (group A strep)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the infecting organism in epiglottitis and how is it treated?

A

Haem. influenzae

Amoxicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How many days can gentamicin be given for and what is its route of administration?

A

3

IV

17
Q

What is given as empiric treatment of an infection of unknown origin?

A

Amoxicillin (gram +ves)
Gentamicin (gram -ves)
Metronidazole (anaerobes)

AGM

18
Q

What broad spectrum antibiotics are most indicated?

A

Co-amoxiclav

Co-trimoxazole

19
Q

What is the main infecting organism in a UTI?

A

E. coli

20
Q

How is cystitis managed?

A

Nitrofurantoin or trimethoprim (3 days)

21
Q

How is pyelonephritis managed?

A

Gentamicin + amoxicillin IV (hosp)

Community: co-amoxiclav OR co-trimoxazole PO

22
Q

What is the risk with treating E. coli gastroenteritis?

A

E. coli 0157 = haemolytic-uraemia syndorme (HUS)

23
Q

What infections is Haem. influenzae indicated in?

What is its treatment?

A

Pneumonia, otitis media, epiglottitis

amoxicillin - despite being gram -ve

24
Q

What are the 4 C antibiotics?

A

Clindamycin
Cephalosporin
Co-amoxiclav
Ciprofloxacin

25
Q

How is C difficile treated?

A

Non-severe: oral metronidazole
Severe: oral vancomycin

(oral as topically available in the gut)

26
Q

What is the typical presentation of c diff?

A

Sevre diarrhoea,

On ABx prophylaxis in hospital following surgery, taking a PPI

27
Q

Give an example of a quinolone? What are the risks associated with them?

A

Ciprofloxacin
Levofloxacin
Moxifloxacin

Tendon rupture, AAA, seizures

28
Q

What is the risk with Gentamicin and what is indicated instead?

A

Kidney damage

Aztreonam is indicated in renal disease (also has gram -ve cover)

29
Q

What type of organism is C. diff?

A

Gram -ve anaerobe