Sepsis/endocarditis

Question 1

What is sepsis syndrome

Answer 1

• Clinical state with obvious indications of altered organ perfusion
  o Altered mentation
  o Oliguria
  o Acidosis
  o Hypoxemia

Question 2

Difference sepsis syndrome vs shock

Answer 2

Altered organ perfusion
o Altered mentation
o Oliguria
o Acidosis
o Hypoxemia
* Septic shock → above + hypotension

Question 3

What is multiple organ dysfct syndrome

Answer 3

septic shock progressed to
o DIC
o Acute respiratory distress
o Acute renal failure
o Hepatobiliary compromise
o Central nervous system dysfct

Question 4

Inflammatory cascade in sepsis

Answer 4

• Macrophages and other inflammatory  → contact with bacterial agent or microbial components/products
• Proinflammatory cytokines released
  o Tumor necrosis factor alpha (TNFα)
  o Interleukine-1 (IL-1)
• Endothelial  and other effector  activation
  o Lymphocyte T and B
  o Monocytes
  o Macrophages
  o Neutrophils
• Release of other inflammatory cytokines
  o IL-8, IL-6
  o Transforming growth factor β
  o Prostaglandin E2
  o Colony stimulating factor
  o Platelet activating factor
  o Eicosanoid
• Activation of complement → coagulation and fibrinolytic cascade

Question 5

Intensity of response controlled by

Answer 5

o Acute phase proteins
o Antiproteases
o Anti inflammatory cytokines
o Anti cytokine substances: IL-1, various R antagonists

Question 6

Septic shock pathophys and steps

Answer 6

• Early in shock → vasodilation → ↑SV and CO
  o Hyperdynamic state
• Venous dilation → venous pooling → ↓preload
• Myocardial depression may occur after 1-4 days of shock
  o LV dilation
  o LV and RV systolic dysfct
  o LV diastolic dysfct

Question 7

Infectious endocarditis isolates: dogs

+ which valves

Answer 7

o Streptococcus
o Staphylococcus
o E coli
o Corynebacterium
o Erysipelothrix

MV and AoV

Question 8

Infectious endocarditis isolates: cats

Answer 8

o Streptococcus
o Staphylococcus

Question 9

Infectious endocarditis isolates: eq

Answer 9

o Streptococcus
o Actinobacillus (corynebacterium)
o Pasteurella

Question 10

Infectious endocarditis isolates: bo

+which valves

Answer 10

o Actinobacillus pyogenes
o Arcanobacterium

TV and PV

Question 11

Infectious endocarditis isolates: pigs

Answer 11

o Streptococcus
o Erysipelothrix