Sepsis

Front 1

SIRS needs >=2 of these 4 conditions

Back 1

-Temperature >38oC or <36oC
-Tachycardia (Heart rate >90 beats/min)
-Hyperventilation (Respiratory rate >20 breaths/min or PaCO2 <32 mm Hg)
-WBC count >12,000/mm3, <4000/mm3, or >10% immature (band) forms

Front 2

Sepsis - definition, manifestation

Back 2

-A systemic inflammatory response to a documented infection.
-Manifestations are the same as SIRS

Front 3

severe sepsis/SIRS - associations, clinical findings

Back 3

-organ dysfunction, hypoperfusion or hypotension.
-lactic acidosis, oliguria or an acute alteration in mental status

Front 4

septic/SIRS shock - definition?

Back 4

-Hypotension despite adequate fluid resuscitation along with organ dysfunction
-An acute alteration in mental status

Front 5

multiple organ dysfunction syndrome - definition?

Back 5

Presence of altered function in more than one organ such that homeostatis cannot be maintained without intervention

Front 6

mortality rates in sepsis

Back 6

SIRS 2: 7%
SIRS 3: 10%
SIRS 4: 17%
Sepsis: 16%
Severe Sepsis: 20%
Septic Shock: 46%

Front 7

risk factors for developing sepsis?

Back 7

Cytotoxic agents
Immune: immunosuppressive agents, AIDS
Malnutrition: Alcoholism, Malignancy, Diabetes mellitus

Front 8

increase in sepsis cases b/c of?

Back 8

transplant recipients

use of aggressive invasive procedures in patient management and diagnosis

resistant organisms

elderly patients

Front 9

Role of TLR1/6 TLR2

Back 9

recognize gram-positive bacteria

Front 10

Role of TLR3

Back 10

recognize double stranded RNA

Front 11

Role of TLR4

Back 11

Recognition of LPS, pili, RSV F protein

Front 12

Role of TLR5?

Back 12

recognition of gram negative flagellin

Front 13

Role of TLR9?

Back 13

recognize unmethylated CpG DNA

Front 14

unmethylated CpG is associated with?

Back 14

-intracellular viral DNA from pathogens
-oncogenes

Front 15

chemokine - definition?

Back 15

chemotactic cytokine

Front 16

cytokines - examples, produced where, released how?

Back 16

-proteins, peptides, or glycoproteins
-produced widely throughout the body by cells of diverse embryological origin
-secreted by immune system

Front 17

pyrogen - definition

Back 17

cytokine that induces elevation in body temperature (via hypothalamus)

Front 18

TLR agonists affect liver and hypothalamus via?

Back 18

-macrophages and epithelial cells
-IL1, IL6, TNF-alpha

Front 19

acute phase reactants from liver include

Back 19

-C-reactive protein
-mannose binding lectin
-surfactants
-complement components

Front 20

neurophil and monocyte infiltration at infection caused by

Back 20

-chemokines
-adhesion molecule expression on neutrophils, monocytes, endothelial cells

Front 21

adhesion molecule expression on neutrophils, monocytes, endothelial cells increased by

Back 21

IL1, IL6, TNF-alpha

Front 22

TLR agonists cause systemic inflammatory response with these three pathways?

Back 22

-cytokines
-complement system
-coagulation

Front 23

cytokine suppression caused by?

Back 23

vagus n. innervating spleen (autonomic nervous system, cholinergic)

Front 24

cytokine promotion caused by?

Back 24

catecholamines (adrenergic)

Front 25

adrenergic definition

Back 25

having to do with adrenaline (epinephrine) and/or noradrenaline (norepinephrine)

Front 26

therapies for sepsis syndrome and septic shock include?

Back 26

-antibiotics
-adequate fluid administration
-oxygen
-vasopressors (norepinephrine)
-activated protein C (rhAPC)

Front 27

DIC - molecular pathway, results in

Back 27

-TLR agonist, tromplastin (Tissue Factor), thrombin, fibrin clots
-hypoperfusion, tissue ischemia, coagulation necrosis, organ dysfunction

Front 28

candidate genes for sepsis outcome modulation include?

Back 28

TNFa,TNFb
IL-1 receptor antagonist, IL-6, IL-10
TLR4, TLR2
CD14

Front 29

protein C maintains hemostasis by?

Back 29

feedback inhibition of prothrombin to thrombin conversion