Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
19 Cards in this Set
- Front
- Back
|
SIRS
|
-systemic inflammatory response syndrome
-Constellation of symptoms that can be the result of infection or other insults such as pancreatitis, burns, trauma, other -hypotension is NOT a criterion |
|
|
Severe sepsis
|
sepsis with 1+ signs of organ failure
|
|
|
Septic shock
|
-sepsis with hypotension despite adequate fluid resuscitation
-has perfusion abnormalities( metal status change, lactic acidosis, oliguria) |
|
|
Epidemiology of severe sepsis
|
• Increasing by 16% per year
• #1 cause of death in non-cardiac ICUs • Mortality rate has declined |
|
|
Systemic inflammatory response syndrome criteria
|
2 of
High or low temp (>38; < 36) Tachycardia (>90 bpm) Fast breathing (>20/min) WBC count > 12,000/mm4 or <4000 or >10% PMNs band neutrophils |
|
|
Organ system involvement in x number of systems for a near 100% mortality rate
|
4
|
|
|
multiple organ dysfunction syndrome
|
dysfunction of 2 or more organ systems
|
|
|
mortality rate for severe sepsis
|
30-40%
|
|
|
Sepsis caused by gram negatives occurs as a complication for these conditions
|
o Complication of UTI, pneumonia, abdominal infection
|
|
|
TLRs lead to signal transduction within the cell
1) TLR for LPS 2) TLR for gram positive |
1) TLR4
2) TLR2 |
|
|
What GPI-anchored protein binds LPS and pulls it closer to TLRs
|
CD14
|
|
|
DIC
|
-overactivation of clotting system and fibrinolytic system
-Clots and bleeding |
|
|
cytokines that are are elevated in sepsis
|
IL-1, Il-6, IL-10, TNF alpha
|
|
|
Usual pathogen for gram postive sepsis
(look over notes for mechanism) |
S. aureus
|
|
|
How do gram positive bacteria cause sepsis and septic shock
|
Lipoteichoic acid activation of cytokines, TLR-2 activation
superantigens toxins (halmark) |
|
|
Ecthyma gangrenosum is associated with what sepsis
|
pseudomonas and other gram negatives
|
|
|
1) What is HRAPC
2) indicated for? 3) mechanism |
1) human recombinant activated protein C
2) indicated for sepsis due to infection with one associated acute organ dysfunction 3) stimulates fibrinolysis by inhibiting factor V, VIII 3b) inhibits LPS and CD14 coupling |
|
|
patient population that tends to benefit from steroids
|
delta cortisol of 9 g/dL after injection
or random total cortisol of 10 g/dL |
|
|
Intensive insulin therapy for hyperglycemia benefits
|
Improves mortality in all types of patients, especially those with multiple organ failure
|
