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21 Cards in this Set
- Front
- Back
Risk Factors For Developing Bloodstream Infection
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Hospitalization
Iatrogenic (IV, catheters, invasive procedures) Complication of localized infections Bacteremial pneumococcal penumonia |
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Risk Factors for Bloodstream Infection
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Burns
Neutropenia Poor nutrition Multiple comorbid conditions Extremes of age Peripheral IV Central venous catheter Arterial catheter |
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Sepsis Pathogenesis
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Bactermia/infection --> systemic inflammatory response --> a. widespread tissue injury and multiorgan failure b. coagulation derangement (DIC)
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Clinical Manifestations of Sepsis
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Fever
Tachypnea Diaphoresis Hypotension Altered mental status Cold extremities Cyanosis Gangrene Oliguria |
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Sepsis Labs
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Leukopenia/leukocytosis
Thrombocytopenia Hypo/hyperglycemia Abnormal liver and renal function Abnormal coagulation Hypoxemia Lactic acidosis |
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Sepsis Respiratory Complications
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Acute respiratory distress syndrome
-leaky capillaries -interstitial and alveolar eema -Hypoxemia -Poor oxygen delivery to tissues |
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Sepsis Hematologic Complications
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Disseminated intravascular coagulation
-consumptive coagulopathy -microgangiopathic hemolytic anemia, schistocytes -widespread activation of clotting cascade --> ischemia/infarction |
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Sepsis Renal Complications
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Acute kidney failure
-acute tubular necrosis -oliguria/anuria |
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Post-splenectomy sepsis
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Streptococcus pneumonia
Neisseria meningitidis H. influenzae Fulminant sepsis due to encapsulated bacteria |
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Hemoglobin Biochemistry
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Globin + 4 heme radicals
Heme complexes with iron atom in center of porphyrin structure |
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Hemoglobin Biosynthesis
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Heme is made from acetic acid and glycine in the mitochondria. 4 pyrrole --> protoporphyrin
Protoporphyrin III + Fe --> heme 4 heme + globin --> hemoglobin Rate limiting step: delta-aminolevulinic acid synthetase |
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Anemia Criteria
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Decrease in hemoglobin per unti volume of blodd below level previously established as normal
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Anemia Symptoms
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Fatigue, dyspnea, chest pain, palpitation, claudications, headache, dizziness, jaundice, pica, pagophagia, dysphagia, Plummer-Vinson syndrome
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Anemia History
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Bleeding, anemia, jaundice
Sulfa drugs, phenytoin, alcohol Sickle Cell, Thalassemia |
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Iron Deficiency Anemia
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Impaired hemoglobinization
Hypochromic (decreased hemoglobin concentration) Microcytic |
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Vitamin B12 Anemia
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Pernicious anemia (lack of intrinsic factor)
-Gastrectomy, irritable bowel disease, bowel resection, absorption problems -neurologic problems -impaired DNA synthesis |
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Folic Acid Anemia
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Megaloblastic anemia
Like B12 without neurological problems Impaired DNA synthesis |
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RBC Production
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Hemocytoblast --> basophil erythroblast --> polychromatphil eryhtroblast --> normoblast --> RBC
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Megaloblastic Anemia Pathology
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Impaired DNA synthesis
Decreased mitotic activity due to lengthening of intermitotic interval Crowded BM Megaloblastic pattern Cells grow large Nuclear-cytoplasmic asynchronism Large, oval, red cells Ovalocytic Leukopenia Thrombocytopenia |
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Iron Toxicity
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GI irritation, necrosis, nausea, vomiting, shock
Pallor, cyanosis, lassitude, drowsiness, hematemesis, diarrhea (green/tarry) CV collapse |
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Hydroxyurea
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Increases amount of Hg F which doesn't contain faulty sickle cell protein
Intermittent blockade of early normoblast maturation |