Term
|
Definition
| -lipopolysaccharide in gram- bacteria cell wall |
|
|
Term
|
Definition
-O-region: highly variable thus difficult for immune system to handle
-R-core: conserved
-Lipid-A: TOXIC PORTION |
|
|
Term
|
Definition
|
|
Term
| Approximately what percentage of colics are due to mucosal compromise w/ endotoxemia? |
|
Definition
|
|
Term
| What causes the systemic inflammation seen w/ endotoxemia? |
|
Definition
-mononuclear phagocyte
-LPS binding protein
-CD-24
-TLR 4
-MD2
-NK-kappaB
-cytokines: IL-1beta, TNFalpha, IL-6, GM-CSF |
|
|
Term
| What causes systemic inflammatory response syndrome (SIRS)? |
|
Definition
-cytokines
-eicosanoids (from arachidonic acid)
-iNOS
-coagulation
-complement |
|
|
Term
| What causes the early vascular response? |
|
Definition
|
|
Term
| What causes the later vascular response? |
|
Definition
-vasodilation
-TNF/IL-1
-PGE2
-PGI2
-bradykinin
-NO |
|
|
Term
| What are the mediators of vascular leak? |
|
Definition
-bradykinin
-PAF
-LTB4
-C3a, C5a |
|
|
Term
| What are the CV consequances of endotoxemia? |
|
Definition
-myocardial depression
-reduced peripheral vascular resistance
-hypovolemia
-microvascular thrombosis |
|
|
Term
| What causes compromised organ perfusion w/ endotoxemia? |
|
Definition
-vasodilation
-coagulation
-capillary leak
-organ failure |
|
|
Term
| Which organs are majorly affected by compromised organ perfusion? |
|
Definition
-kidney
-CV
liver
-HOOG**** |
|
|
Term
| What are the CS of endotoxemia? |
|
Definition
-MM: pale, toxic line, brick red
-CRT
-poor peripheral pulses
-cool extremities
-restlessness, colic
-coagulopathy
-m tremors
-sweating |
|
|
Term
| What are our goals of treating endotoxemia? |
|
Definition
-improve perfusion/supportive care
-remove srce: sx resection
-inh specific infalmm mediators
-bind endotoxin |
|
|
Term
| what are our methods of circulatory support for endotoxemia? |
|
Definition
-balanced crystalloids: normosol, LRS
-colloids (esp foals): plasma, dextrans, hetastarch
-hypertonic saline: ADULTS ONLY
-ionotropes, pressors |
|
|
Term
| How do we guide our fluid deficit w/ endotoxemia? |
|
Definition
|
|
Term
| What are the common eletrolyte deficits that occur w/ colitis? |
|
Definition
-metabolic acidosis
--hyponatremia
-hypochloremia
-hypokalemia
-hypocalcemia |
|
|
Term
| What causes metabolic acidosis w/ endotoxemia? |
|
Definition
-bicarb loss: diarrhea
-lactic acidosis: hypovolemia
-total CO2
-blood gas: bicarb |
|
|
Term
| At what point do we fix metabolic acidosis? |
|
Definition
|
|
Term
| What does hypertonic saline stimulate? |
|
Definition
-myocardial contractility
-vagovagal reflexes |
|
|
Term
|
Definition
-acute phase proteins
-immunoglobulins
-coagulation factors |
|
|
Term
| What is our major concern w/ ionotropes & pressors? |
|
Definition
|
|
Term
| What are the ionotropes & pressors used to treat endotoxemia? |
|
Definition
|
|
Term
| Describe the supportive care of endotoxemia. |
|
Definition
-immunosuppression: neutropenia, antimicrobials
-nutritional support: usually for septic neonates |
|
|
Term
| Describe the anti-inflamm therapy of endotoxemia. |
|
Definition
|
|
Term
| What is Pentoxifylline? What does it do? |
|
Definition
-phosphodiesterase inh, inh tumor necrosis factor
-blocks endotoxin mediated cytokine, thromboxane & thromboplastin pdn |
|
|
Term
| What is the use of hyperimmunized plasma & serum for treating endotoxemia? |
|
Definition
-ab bind LPS
-conflicting experimental results |
|
|
Term
| What is the benefit of polymixin B for treating endotoxemia? |
|
Definition
-BS cyclic peptide abx
-nephrotoxic
-caution if azotemic |
|
|
Term
| What are the clinical complications of dz asoc w/ endotoxemia? |
|
Definition
-renal compromise: minimize NSAID, mmonitor
-thrombophlebitis: monitor catheter & remove if necessary
-laminitis |
|
|
Term
| How do we prevent/treat laminitis? |
|
Definition
-heparin
-aspirin
-DMSO
-flunixin meglumine
ice boots to proximal metacarpus |
|
|
Term
| What drugs do we use to improve blood flow w/ Laminitis? |
|
Definition
-Acepromazine
-Nitroglycerine patches, ointment
-pentoxifylline |
|
|
Term
| How do we mechanically treat laminitis? |
|
Definition
-sand
-styrofoam pads
-shoeing: heel elevation, sole support, change breakover |
|
|
