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Pathophysiology - year 3 > Sepsis & Shock > Flashcards

Sepsis & Shock Flashcards

1
Q

presence of systemic inflammatory response syndrome (SIRS) in addition to a documented or presumed infection

A

Sepsis-2

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2
Q

presence of 2 or more of the following:

  • fever >38 or <36
  • HR > 90
  • RR >20 or PaCO2 <32 mmHg
  • abnormal WBC count >12000 or <4000 or >10% immature band forms
A

SIRS

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3
Q

life-threatening organ dysfunction due to a dysregulated host response to infection

A

Sepsis-3

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4
Q

Three criteria to calculate qSOFA score

A
  • hypotension (SBP <100)
  • Altered mentation (Glasgow coma scale <15)
  • Tachypnea (>22)
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5
Q

subset of sepsis in which underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality

A

Septic Shock

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6
Q

What are the clinical criteria for septic shock?

A
  • Sepsis
  • Hypotension requiring vasopressors to maintain mean arterial pressure >65 mm Hg despite fluid resuscitation
  • Lactate > 2 mmol/L
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7
Q

List SOFA variables

A
  • PaO2/FiO2 ratio
  • Glasgow coma scale score
  • Mean arterial pressure
  • administration of vasopressors with type and dose rate of infusion
  • serum creatinine or urine output
  • bilirubin
  • platelet count
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8
Q

What are the most common co-morbidities in sepsis patients?

A

Diabetes and cancers

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9
Q

What is the most appropriate plan of action for a client with septic shock?

A

Provide early cardiovascular support for IV fluids and vasoactive agents to maintain CVP, MAP, and ultimately tissue perfusion.

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10
Q

Reduced stroke volume (or heart rate) causes what type of shock?

A

Cardiogenic

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11
Q

Impaired flow causes what type of shock?

A

Obstructive

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12
Q

Reduced preload causes what type of shock?

A

Hypovolemic

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13
Q

Reduced systemic vascular resistance causes what type of shock?

A

Distributive

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14
Q

Heart attack, viral heart infection, conduction abnormality, severe heart valve problems

A

Cardiogenic

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15
Q

Massive pulmonary embolism, significant pericardial effusion, tension pneumothorax, cardiac tumour

A

Obstructive

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16
Q

Bleeding (trauma, ulcer), dehydration (heat, shock, diuretics, diarrhea)

A

Hypovolemic

17
Q

Sepsis, anaphylaxis, adrenal insufficiency, acute hepatitis, over active thyroid, acute spinal cord injury

A

Distributive

18
Q

What contributes to the pathogenesis of organ dysfunction, sepsis, and shock?

A

hypoxia, mitochondrial/cellular/immune dysfunction, loss of systemic homeostasis, and barrier failure.

19
Q

part of the innate immune system that reacts rapidly when the tissue injury is detected

A

the inflammatory response

20
Q

what is the largest group hospitalized for sepsis?

A

those over 65 years

21
Q

what gender is sepsis more common in?

A

males

22
Q

___ is a hallmark of sepsis, causing depletion of ATP

A

mitochondrial dysfunction

23
Q

___ sepsis accounts for much of the sepsis hospitalization in the very young.

A

neonatal

24
Q

pyruvate must be converted to ___ to allow energy production to continue

A

lactate

25
Q

ongoing anaerobic metabolism results in a _____

A

drop in pH due to lactic acid buildup

26
Q

one type of shock that involves bradycardia + warm/dry skin

A

neurogenic shock

27
Q

what do the acinar cells generate?

A

proteolytic enzymes, amylase and lipases in nonactive forms

28
Q

what activates the proteolytic enzymes

A

trypsin

29
Q

what is the most common symptom in pancreatitis?

A

severe epigastric or mid-abdominal pain

30
Q

what is the preferred drug for pain relief in pancreatitis?

A

meperidine hydrocholride or Demerol

31
Q

what is the most specific and sensitive diagnostic marker for pancreatitis?

A

elevated serum lipase level

32
Q

what is used to evaluate disease severity in pancreatitis?

A

C-reactive protein (CRP)

33
Q

2 most common causes of pancreatitis

A

gallstones or alcoholism

Pathophysiology - year 3 (8 decks)

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