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BDS2 BAMS > Sepsis > Flashcards

Sepsis Flashcards

1
Q

Sepsis is NOT an infection. Can sepsis occur in the absence of an infection?

A
  • No, sepsis does not occur in the absence of infection
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2
Q

What is sepsis?

A
  • A life-threatening organ dysfunction due to a dysregulated host response to infection
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3
Q

What is sepsis triggered by?

A
  • Triggered by infection in a susceptible patient)
  • This causes an overwhelming immune response that causes organ dysfunction
  • (presence of organ dysfunction differentiates sepsis from infection)
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4
Q

Is sepsis associated with a high risk of mortality?

A
  • Yes
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5
Q

What 3 things need to be identified by qSOFA for someone to have sepsis?

A
  • Respiratory > or equal to 22 breaths/min
  • Altered mentation (Glasgow coma scale <15)
  • Systolic BP < or equal to 100mmHg
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6
Q

What does SOFA stand for?

A
  • Sepsis-related organ failure assessment
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7
Q

What is septic shock?

A
  • A subset of sepsis
  • Sepsis in which the underlying circulatory and cellular and/or metabolic abnormalities are marked enough to substantially increase mortality
  • Clinically defined as sepsis with persisting hypotension that requires vasopressors to maintain the mean arterial pressure at greater than or equal to 65mmHg and with a serum lactate concentration of greater than 2mmoll-1
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8
Q

What is qSOFA?

A

A tool to clinically characterise patients at risk of sepsis

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9
Q

What should the baseline qSOFA score be?

A

Should be 0 unless a patient has a pre-existing organ dysfunction BEFORE onset of infection

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10
Q

What is the overall mortality risk for a patient with a qSOFA score of > or equal to 2?

A

Overall 10% mortality risk - requires prompt medical intervention

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11
Q

What are the 3 criteria you are looking for in the Glasgow coma scale?

A
  • Eye opening
  • Verbal response
  • Best motor response
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12
Q

What causes sepsis?

A

Any infection can trigger sepsis

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13
Q

Where are common sites of infection at can trigger sepsis? (4 points)

A
  • Lungs (64%)
  • Abdomen (20%)
  • Bloodstream (15%)
  • Urinary system (14%)
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14
Q

What are examples of microbial factors that can cause some infections to progress to sepsis? (5 points)

A

Virulence factors:

  • LPS
  • Lipoteichoic acid
  • Peptidoglycan
  • Pili, fimbriae, capsule etc

Virulence contributes to pathogenicity (the ability of a microbe to cause disease)

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15
Q

What are examples of Host factors that can cause some infections to progress to sepsis? (6 points)

A
  • Innate immunity
  • Adaptive immunity
  • Immuno-compromised (HIV/AIDS, cancer, auto immunity, organ transplant)
  • Pre-existing chronic conditions (diabetes, cirrhosis, CKD)
  • Age
  • Genetics
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16
Q

Which part of the population most commonly gets sepsis?

A
  • The ageing population
17
Q

Sepsis disproportionally affects medically and immune-compromised patients. What are examples of medically conditions that can increase a patients susceptibility? (6 points)

A
  • Cancer
  • Cirrhosis
  • Autoimmunity
  • HIV/aids
  • Organ transplantation
  • Diabetes
18
Q

What are common pathophysiology signs of sepsis? (4 points)

A
  • Dysregulated, excessive systemic inflammation
  • Body-wide blood clotting and ‘leaky vessels’
  • One or more organs beginning to fail
  • Persistent hypotension
19
Q

What is acute inflammation?

A
  • A protective immune reactions when it identifies invading microorganisms or endogenous signals from damaged cells
20
Q

Acute inflammation gives rise to the cardinal signs of inflammation which are localised to the site of infection. What does this lead to? (3 points)

A
  • Leads to the clearance of the source of injury and necrotic tissue
  • Followed by tissue repair and
  • Return to homeostasis
21
Q

What is the process of the innate immune system response to infection? (5 points)

A
  • Innate immune system recognises PAMP’s and DAMP’s through PRR’s and is activated
  • Cells detect this signal and respond through the release of cytokines and chemokines
  • Cytokines activate endothelial cells, vasodilation and vascular permeability
  • Large amounts of cytokines activate acute phase proteins int he liver, platelet activation and symptoms of fever
  • Activation of complement
22
Q

Is resolution of inflammation an active or passive process?

A
  • Active

- Involves several regulatory mechanisms

23
Q

You get immune suppression via anti-inflammatory mediators. What are 2 examples of these?

A
  • IL-10

- TGF-b

24
Q

In sepsis, the immune response fails to eliminate the pathogen. This causes localised acute inflammation to progress to what?

A
  • Progresses to acute systemic inflammation
25
Q

Do patients with sepsis demonstrate excessive inflammation and immune suppression?

A
  • Yes
26
Q

What processes causes the excessive inflammation in people with sepsis? (3 points)

A
  • Strong activation of innate immunity via PAMP’s and DAMP’s
  • Sustained hyperinflammation
  • Activation of complement system, coagulation system and vascular endothelium
27
Q

Does sustained inflammation cause tissue injury?

A
  • Yes
28
Q

What causes immune suppression in people with sepsis? (4 points)

A
  • Both innate and adaptive immunity
  • Apoptosis of T cells and B cells
  • Dysfunctional dendritic cells
  • Delayed apoptosis of immature dysfunctional neutrophils
29
Q

What are 2 treatments that should be given to patients with sepsis early?

A
  • Early IV of antibiotics is essential to limit the spread of infection
  • Fluids are given early as well
30
Q

Why should dentists care about sepsis?

A
  • Sepsis is a rare but potentially serious complication of acute dental infections
31
Q

What oral conditions could be a potential source of sepsis ? (3 points)

A
  • Abscesses
  • Caries
  • Fungal infections
32
Q

Why do dental abscesses develop?

A
  • Develop as a consequence of acute inflammatory response to bacterial infection
33
Q

What do dental abscesses contain? (3 points)

A
  • Immune cells, dead tissue, LIVE bacteria
34
Q

Are dental abscesses highly infective?

A
  • Yes
35
Q

How would you treat a dental abscess? (2 points )

A
  • Treated promptly by excision and drainage

- Periapical abscesses require root canal treatment or extraction

36
Q

Are antibiotic effecting in treating abscesses?

A
  • no
37
Q

Can dental abscesses spread and lead to severe local and systemic consequences?

A
  • Yes
38
Q

What are the red flag signs and symptoms of spreading dental infections? (6 points)

A
  • Temp 38
  • Elevated breathing rate (>20 breaths/min)
  • Elevated or reduced heart rate
  • Varying degrees of facial swelling
  • Trismus
  • Dehydration
39
Q

What is trismus?

A

Spasm of the jaw muscles, causing the mouth to remain tightly closed

BDS2 BAMS (57 decks)

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