Wk 25: Signs and symptoms of infection

Question 1

What is an advantage of CRP levels?

Answer 1

High = bacterial infection, low = viral infection

Question 2

When do CRP levels tend to rise?

Answer 2

2hrs of inflammatory event

Question 3

What is used to identify organisms?

Answer 3

• PCR
• Microscopy
• Microbial culture

Question 4

What are the sepsis 6?

Answer 4

• Oxygen
• Cultures
• IV antibiotics
• Fluid resuscitation
• Blood tests (lactate)
• Fluid balance/urine output

Question 5

Which lactate levels indication an admission to ICU?

Answer 5

4mmol/L

Question 6

At what lactate levels would you see shock or hypoperfusion?

Answer 6

2mmol/L

Question 7

What is lactate?

Answer 7

Metabolite of glucose prod by tissues under insufficient oxygen supply

Question 8

What is inapparent infection?

Answer 8

Active infection but does not produce noticeable symptoms

Question 9

What are the disadvantages of CRP?

Answer 9

Serum CRP ranges overlap + CRP rise in response to inflammation - not only infection

Question 10

Which patients would you be worried for, in a case of sepsis?

Answer 10

• Infants
• Immunocompromised
• Catheters
• Recent surgery

Question 11

What is start smart then focus?

Answer 11

Start:
- Don’t start antimicrobial unless clear evidence of infection

• Take thorough drug allergy hx
• Avoid inappropriate use of broad spec

Focus:

• Review diagnosis + continue abx at 48-72hrs

Question 12

What are the 5 antimicrobial prescribing decisions?

Answer 12

• Start abx if no evidence of infection
• Switch IV to oral
• Change to narrow spec
• Continue + document review date
• OPAT