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14 Cards in this Set
- Front
- Back
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What is the definition of shock? . What is the definition of severe sepsis? . What is the definition of septic shock? |
1) Sepsis - Is defined as SIRS resulting from a documented presumed infection. 2) Severe sepsis - sepsis complicated by organ dysfunction, hypotension before fliod challange or lactate >4mmol/L 3) Septic shock - sepsis will persistent hypotension despite adequte fluid recusitation. . Hypotension being defines as SBP <90 mmHg or MAP <65mmHg or drop in SBP of >40mmHg from baseline. |
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Warm vrs cold septic shock? |
- warm shock is characterised by high CO and low peripheral vascular resistance (vasodilation) and occur first (early septic shock which is reversable) - Most patients will remain in warm shock for 6-72hrs before entering cold shock (decreased CO and elevated systemic vascular resistance (refractory septic shock) - This late and nearly irreversible phase of septic shock is usually indistinguishable from terminal hypovolemic shock. |
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What are the three clinical charcteristics of sepsis and how many does the patient need before they're deemed septic? |
Two or more of the following; 1) temp >38C - <36C 2) Pulse rate >90 bpm 3) Respiratory rate >20/min |
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What is septic shock charcterised by? |
By sepsis and hypotension and can lead to multiple organ dysfunction and death. |
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What are some clinical features of sepsis? |
- temp >38C or <36C - obvious source of infection with sepcific features (eg, pneumonia with cough? - resp distress, PO - tachycardia, tackypnoea, mottled skin - other signs of hypoperfusion (reduced uring, ALOC) |
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How much fluid sould you be giving a septic patient? . What other vital sign should you keep an eye on? |
Agressive fluid resuscitation - large volume fluid boluses, don't overload them. KEEP A RADIAL PULSE. If they are shocked consider Adrenaline (ICP) . Keep an eye on BGL. |
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What is the pathophysology of septic shock? |
- Hypermetabolic state - increased oxygen consumtion, global tissue hypoxia and stress hyperglycemia. - Major organ dysfuncion - hypotension and hypoxia. - SEPTIC SHOCK IS A COMBINATION OF ALL THREE CLASSES OF SHOCK. Hypovolemic shock - intravascular fliod loss occues through capillary lead. Cardiogenic shock - myocardial depressant effects of sepsis. Distributive shock - decreased systemic vasculr resistance. |
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What does SIRS stand for and what are the parts of it? And what can it be a response to? |
- temp >38.3C or <36C - Heart rate >90 bpm - RR >20 or PaCO2 <32mmHg - WBC >12,000 or <4,000 or >10% immature bands. - The physiologic response of the human body to a cariety of clinical insults. - Can develop in response to a number of stressors; infectionus, toxicological, traumatic, ischaemin, immunologic. |
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What is meningitis? |
Inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. The inflammation may be caused by infection with viruses, bacteria, or other microorganisma, and less commonly by certian drugs. |
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What are the signs and symptoms of meningitis? |
Neck stiffenss, headache, fever, photofobia, phonophobia, altered mental status, irritability, nuchal regidity, positive Kernings and/or Brudzinskis sign. |
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How many different strains of meningococcal infections are there and what is the main one? . What is the name of the bug? |
Five or six different strains - most being caused by strain B. There are strains A, B, C, Y and W 135 subgroups. . Neisseria meningitidis. Transmitted by respiratory droplets. Incubation period for 3-5 days while the infectious bacteria remains in the nasal and pharyngeal discharges for days to weeks. |
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What group of Meningococcal disease does not have a vaccination? |
serogroup B, the seasonal peak is in winter and spring. |
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What are the four main pathophysiological processesaffecting the microvasculature? |
1) Increased vascular permeability 2) Pathological vasoconstriction and vasodilation 3) Loss of thromoresistance and intravscular coagulation 4) Profound myocardial disfunction |
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What is the purpuric rash? . What is the patechial rash? . What is the maculoparular rash? |
Little capillary haemorage, often on arms and trunk. Purpura meaning purple. . pinpoint, round spots that appear on the skin as a result of bleding under the skin. Can be red, brown or purple. It appears in clusters. . A type of rash thats charcterised by flad, red, small condluent bumps. It might only appear on lighter-skinned people. |
