Term
| What are the 4 signs of SIRS? |
|
Definition
1) Temp >38C or <36C
2) HR >90
3) Respirator rate >20, PaCO2 <32
4) WBC >12,000 or <4,000 |
|
|
Term
| In humans what receptor bind endotoxin an alert the innate immune system for the development of shock? |
|
Definition
| Toll-like receptors (TLB) |
|
|
Term
| CD 14 molecules do what for lipopolysaccharide (LPS) signaling? |
|
Definition
| potentiate the host response to small quantities of LPS |
|
|
Term
| bacterial superantigens do what? |
|
Definition
| activate large numbers of CD4 cells |
|
|
Term
| What are the major inflammatory cytokines of sepsis? |
|
Definition
|
|
Term
CD4 T cells when exposed to IL-12 do what?
When exposed to IL-4? |
|
Definition
IL-12 - produce copious amounts of interferon gamma, TNF-a, and IL-2-promote cell-mediated response
IL-4-promote humoral immune response |
|
|
Term
| TH1 type cytokines do what? |
|
Definition
| suppress expresion of TH2 cytokines |
|
|
Term
| What happens to the coag system during sepsis? |
|
Definition
| becomes activated via extrinsic pathway causing diffuse microthrombi. Activation of intravascular coagulation leads to hemorrhagic diathesis |
|
|
Term
| Release of NO causes what in sepsis? |
|
Definition
| vasodilation and systemic hypotension-regulates platelet and neutrophil adherence |
|
|
Term
| What simplified process leads to organ dysfunction? |
|
Definition
| diffuse endothelial injury |
|
|
Term
| What are the most common hemodynamic findings in early shock? |
|
Definition
| high cardiac output and low systemic vascular resistance |
|
|
Term
| What is a major cause of mordibity and Mortality? |
|
Definition
| ARDS from increased capillary permeability |
|
|
Term
| What are the 4 goals of shock treatment? |
|
Definition
1) early recognition and resuscitation
2) tissue perfusion and blood pressure
3) optimal supportive care
4) timely initiation of treatment to eradicate causative organism |
|
|
Term
| What is the mandatory first step in the treatment of shcok? |
|
Definition
| fluid resuscitation with isotonic solution |
|
|
Term
| What is a new therapy that inhibits thrombin production and is proven successful in helping the sickest patients? |
|
Definition
| recombinant human activated protein C (drotrecogin alfa activated) (Xigris) |
|
|
Term
| What seems to the be the most reliable and specific indicator of severe septic shock available? |
|
Definition
|
|
Term
| What seems to the be the most reliable and specific indicator of severe septic shock available? |
|
Definition
|
|
