Micro test 2

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  1. Atypical
    Not typical, really relates to the cell wall
  2. The 3 groups of mediators in LPS and sepsis
    Proteins, oxygen free radicals, and lipids
  3. Mediator group 1: Proteins
    • Tumor Necrosis Factor
    • Interleukin-1
    • Interleukin-6
    • Interleukin-8
  4. Mediator group 2: Oxygen Free Radicals
    • Oxygen (O2-)
    • Hydrogen Peroxide (H2O2)
    • Nitric Oxide (NO)
  5. Mediator group 3: Lipids
    • Prostaglandin E2
    • Thromboxane A2
    • Platerlet-activation factor
  6. When mediator levels are low
    • Low = Beneficial effects
    • Moderate fever
    • Generalized stimulation of immune system
    • Microbial killing
  7. When mediator levels are high
    • High = Harmful effects
    • High fever
    • Hypotension
    • Disseminated blood clotting
    • Lethal shock
  8. Cechectin
    Was used back in the day for treatment of cancer
  9. Worlds most potent oxidizing agents
    • Nitric oxide
    • Single Oxygen Perhydroxyl
    • Peroxide
  10. Hypotension
    Low blood pressure
  11. Potent Oxidizing Agents
    Can bust causing water to leak out which then can cause low blood pressure
  12. Mottled Skin
    Looks like bruises but is indicative of blood vessel damage
  13. True or False: Monitoring lactate determines/is relevant to the diagnosis and the treatment or lack of treatment.
  14. Cryptic Septic Shoch
    CO2 levels are being monitored to detect the cryptic septic shock
  15. Refractory Septic Shock
    Inability of the patient to normalize organ function despite the attempts to correct imbalances. Also patients at this stage are more likely to die than those with other stages of presentation
  16. Atypical bacteria
    Mycoplasma and archaea
  17. "L" Forms
    • Lack a cell wall
    • Produced by antibiotic action
    • Wall may reform
    • Associated with SBE
  18. SBE treatment
    • SBE = Subacute Bacterial Endocarditis
    • Requires various antibiotics:
    • Beta Cactam which inhibits cell wall formation
    • Aminoglycoside - Inhibit protein synthesis
    • Idea is you want to attack the cell wall and protein synthesis of the cell cuz not likely to develop resistance 2 both drugs at the same time
  19. Rickettsia
    • Obligate intracellular pathogens
    • Include: rocky mountain spotted fever
    • Lack cell wall
    • Cannot be cultured artificially
  20. Chlamydia
    • Similar to rickettsiae as energy parasite
    • Have complex life cycle elementary and reticulate bodies
    • Cannot be grown artificially, have to be grown in tissue culture
  21. Species associated with human disease
    • C. Trachomatis = STD
    • C. Pneumoniae = Pneumonia
    • C. Psittacii = Ornithosis/psittacosis
  22. Mycoplasma
    • Lack cell walls
    • Contain streols in the cell membrane - unusual for prokaryotes, typical in eukaryotes
  23. Human Infections caused by Mycoplasma
    • M. Pneumoniae = Primary atypical pneumonia
    • M Urealitycum = Genital Mycoplasma
    • Non Specific urethritis
  24. Archaea
    • Ancient bacteria
    • Cell walls lack peptidoglycan
    • Have Pseudomurein
    • Include Halophiles, Thermophiles, Methanogens
    • Not human pathogens since conditions are not appropriate for growth
  25. Screening for Sepsis and Septic Shock
    • Any patient who has an infectious process (like uti) cuz it can spread into blood and become sepsis and septic shock
    • All critically ill patients
    • Severe CAP (community-acquired pneumonia)
    • Intra-abdominal surgery
    • Meningitis
    • Chronic diseases (including diabetes, heart failure, chronic renal failure, and COPD)
    • Compromised immune statues (including HIV/AIDS, use of cytotoxic and immunosuppressive agents, alcoholism)
    • Cellulitis
    • Urinary tract infection
  26. When screening is essential:
    • ICU - where 1/10 admissions to the ICU involves severe sepsis
    • Unit Admission (criteria)
    • Admission assessment
    • Nurse shift changes - to combat this you write notes and have reports to insure continuity of treatment
    • Existing care protocols and pathways
    • Multidisciplinary rounds - Ground runs = patient is critically ill and all specialties are involved
    • Deterioration in patients clinical or laboratory paramaters - examine vital signs for deterioration
    • Present in ER - 37% of severe sepsis patients present in ER
    • Initial assessment
    • Pharmacy - combination of therapies can alert the clinical team to possible clinical indicators of severe sepsis
    • Antibiotics (infection) + Vasopressor (organ dysfunction)
  27. True or False: How do you save a patient who is showing signs of septic shock?
    Early aggressive intervention with supportive after care
  28. How do you know is patient is susceptible for septic shock?
    • If they have any illness
    • Vitals
  29. Signs and Symptoms of Septic Shock
    • Cool pale extemities
    • High or very low body temperature - chills
    • Lightheadness
    • Low blood pressure - especially when standing
    • Low urine output - kidney failure
    • Palpitations
    • Rapid heart rate
    • Restlessness, agitation, lethargy, confusion
    • Shortness of breath
Card Set
Micro test 2
Micro test 2
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