Sepsis Flashcards
1
Q
pathophysiology of sepsis
A
large immune response:
- nitrous oxide release – vasodilation (decreased BP)
- oedema + reduced intravascular volume as endothelial lining of blood vessels becomes more permeable – fluid leaks into extracellular space
- activation of coagulation system – DIC: thrombocytopenia + haemorrhages
- tissue hypoperfusion causes blood lactate to rise from anaerobic respiration
2
Q
septic shock
A
systolic BP <90 despite fluid resuscitation or
hyperlactaemia (>4 mmol/L)
3
Q
what is often the first sign of sepsis
A
tachypnoea
4
Q
sepsis 6
A
Take 3:
- blood lactate level
- blood cultures
- urine output
Give 3:
- Oxygen
- Broad spectrum antibiotics
- IV Fluids
5
Q
blood tests for patients with suspected sepsis
A
FBC U+Es - assess for kidney function + AKI LFTs - asses liver function CRP - assess inflammation Clotting - assess for DIC Blood culture - assess for bacteraemia Blood gas - assess lactate, pH, glucose
6
Q
what is neutropenic sepsis
A
sepsis in a patient with a low neutrophil count
7
Q
what can cause neutropenia
A
chemotherapy clozapine hydroxychloroquine carbimazole methotrexate quinine suflasalazine rituximab
8
Q
threshold for suspecting neutropenic sepsis in patients taking medications that can cause neutropenia
A
treat any temperature above 38 degrees as neutropenic sepsis until proven otherwise
9
Q
antibiotic for neutropenic sepsis
A
piperacillin with tazobactam (tazocin)
