Severe infection & sepsis Flashcards

1
Q

Define infection

A

Invasion & multiplication of pathogenic microbes

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2
Q

Define SIRS

A
systemic inflammatory response syndrome
>1 of:
- temperature 38°C
- heart rate >90/min
- respiratory rate >20/min or pCO2 12x109/dl or >10% immature WBCs
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3
Q

Define sepsis

A

systemic inflammatory response to infection (SIRS + known or suspected infection)

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4
Q

Define severe sepsis

A

sepsis + organ dysfunction (including septic shock)

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5
Q

Define septic shock

A

sepsis + hypotension (SBP

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6
Q

What is the sepsis 6?

A

Within 1 hour of suspecting severe sepsis → Sepsis Six Care Bundle:

  1. Give high-flow oxygen
  2. Take blood cultures – identify what’s in the blood to get right ABX
  3. Give empirical IV antibiotics – don’t know what best ABX is
  4. Measure FBC & serum lactate (what’s going on in tissues)
  5. Start IV fluid resuscitation
  6. Start accurate urine output measurements
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7
Q

Which viruses & bacteria can cause bronchitis?

A
  • Viruses - rhinovirus (cold), influenza

- Bacteria - strep, haemophilus influenzae

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8
Q

What are the signs & symptoms of bronchitis?

A

Symptoms - dyspnoea, cough, sputum (usually), wheeze

Signs - fever (usually), tachypnoea, crackles, wheeze

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9
Q

What is the pathology of bronchitis?

A

Infection & inflammation of airways

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10
Q

What is the pathology of pneuomonia?

A

infection & inflammation of alveoli

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11
Q

What viruses & bacteria can cause pneumonia?

A

Viruses - influenza

Bacteria - strep, staph

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12
Q

What are the signs & symptoms of pneumonia?

A

Symptoms - dyspnoea, cough (usually), sputum (usually), pleurisy

Signs - fever, tachypnoea, crackles, ↓ or bronchial breath sounds (more loudly due to consolidation within area of lung)

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13
Q

Is sepsis common in bronchitis or pneumonia?

A

Pneumonia

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14
Q

What investigations would be done for lower respiratory tract infections?

A
  • PEFR – airway constriction
  • Full blood count – increased leukocytes
  • U+Es
  • CRP – increased in bacterial infection
  • Lactate – in severe sepsis – tissues not working properly
  • ABGs – hypoxia +/- hypercapnia
  • CXR – shadowing consistent with pneumonia. (not good at seeing bronchitis)
  • Nose & throat swabs – for viral investigations
  • Sputum – for bacterial investigations
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15
Q

When would you admit someone to hospital with a LRTI?

A
CURB-65 -->
- Confusion
- Urea >7mmol/L – kidney injury
- Respiratory rate >30/minute – normal is 12-16/min
- Blood pressure 1 → admit
•	If score >2 → IV treatment
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