Session 3 - Acute Sepsis Flashcards
Define Sepsis
A life-threatening organ dysfunction due to a dysregulated host response to infection
What urgent investigation need to be taken if sepsis is suspected?
- Full Blood Count, U’s and E’s
- Blood Sugar
- Liver Function
- CRP
- Coagulation Studies
- Blood Gases
Give the sepsis six bundle
- Give high flow oxygen
- Take blood cultures
- Give IV antibiotics
- Give a fluid challenge
- Measure lactate
- Measure urine output
How does an infection trigger an inflammatory response?
When a macrophage phagocytoses a microbe, endotoxins are released which bind to the macrophage and cause it to release Cytokines such as TNF and IL-1
How does sepsis cause organ failure?
The uncontrolled release of cytokines initiates the production of thrombin and inhibits fibrinolysis. The coagulation leads to micro vascular thrombosis which can lead to organ ischaemia and failure.
What is the empiric choice of antibiotic to give to a septic patient?
Ceftriaxone
What are some of the life-threatening complications of sepsis?
- Irreversible Hypotension
- Resp failure
- Acute kidney injury
- Increased intracranial pressure
- Ischaemic necrosis of the digits
Describe Neisseria Meningitidis
- Likely diagnosis for sepsis
- spread by direct contact with resp secretions
- most people are harmlessly colonised, but in a few can be fatal
- G -ve diplococcus with a pilus which enhances attachment to mucous membranes
What two ways can be prevent Meningococcal disease?
Vaccination or Antibiotic Prophylaxis
Name some physical barriers to infection.
- Skin
- Mucous Membranes
- Bronchial cilia
Name some physiological barriers to infection
- Diarrhoea
- Vomiting
- Coughing
- Sneezing
Name some chemical barriers to infection
- low pH in many parts of body (skin, stomach, vagina)
- anti microbial molecules (IgA, Lysozyme)
What is our main biological barrier to infection and how does it prevent infection?
Normal Flora
Compete with pathogens for space and growth substances, produce anti microbial chemicals and synthesise vitamins
When can normal flora cause clinical problems?
- When they are displaced to a sterile location
- When displaced from their normal location
- When they overgrow and become pathogenic
- when normal fora is depleted by antibiotics
Name the main cellular components of the innate immune system
- Macrophages
- Monocytes
- Neutrophils
