4 11S Id Multiple Organ Dysfunction Em

Front 1

Definition of MODS

Back 1

MODS - presence of altered organ function in an acutely ill pt such that haemeostasis cannot be maintained without intervention. The common pathway for the critically ill. Dysfunction of more than one organ that requires intervention

Front 2

Name some mediators of sepsis

Back 2

1 cytokines (TNF alpha is the initial cytokine, IL also play a key role esp IL1 and TNF are key mediators and increased levels correlate with clinical status; they activate leucocytes and GCSF)
2. Prostaglandins are responsible for fever, elevated thromboxane A2 levels are also found in sepsis
3. Vasopressin (briefly rises in sepsis and then has a prolonged and severe suppression)
4.NO (production enhanced, contributes to vasodilation)

Front 3

Organs involved in MODS, T or F
1. Mortality rates in pts with septic encephalopathy is higher than in septic pts without
2. Cardiovascular compromise in septic shock is often irreversible
3. Pulmonary compromise is common and rarely lethal
4. GI dysfunction is uncommon as splanchnic blood flow is independent of MAP due to local autoregulation
5. Both augmentation and suppression of the hypothalamic pituitary axis is possible
6. Increased production of essential coagulation factors causes DIC
7. Impairment of Protein C dependent anticoagulation pathway is critical to the development of thrombotic complications in sepsis

Back 3

T
F - function usually returns within 10 days
F - often lethal. Common endpoint is ARDS (impaired oxygenation, bilateral pulmonary infiltratres, lowered pulmonary artery occlusion pressure)
4. F Splanchnic flow is dependent on MAP due to limited autoregulation. Hollow visci are significantly affected by shock.
5. T
6. F - increased CONSUMPTION causes DIC
7. T