Pathology Notes

Sepsis Updated: 06/28/2022 © Jun Wang, MD, PhD   Definition Life threatening organ dysfunction caused by a dysregulated host response to infection General features Organ dysfunction identified by acute change of 2 or more points in total SOFA score or qSOFA Likely prolonged ICU stay Relatively high mortality rate Commonly associated with infections of injury or internal organs and perforation/rupture of abdominal/pelvic structures Most commonly caused by bacterial infections, but can be caused by virus or fungi Systemic Inflammatory Response Syndrome (SIRS) A term being abandoned since 2016 Still being used clinically Poor mortality prediction comparing with Sequential Organ Failure Assessment (SOFA) Clinical responses to either infectious or non-infectious causes Sequential Organ failure Assessment (SOFA) A systemic evaluation of organ function Performed in critically ill patients with suspected sepsis Systems involved o    Cardiovascular: Blood pressure o

Obstructive shock Updated: 06/30/2022 © Jun Wang, MD, PhD General features Reduced cardiac output due to obstruction of large vessels or heart Similar symptoms to cardiogenic shock , but different treatment Usually clinical diagnosis, based on history and clinical presentations Etiology Pulmonary vascular Pulmonary embolism Severe pulmonary hypertension Pulmonary or tricuspid stenosis, acute obstruction Mechanical Tension pneumothorax Pericardial tamponade Constrictive pericarditis Restrictive cardiomyopathy High-PEEP ventilation Vena Cava compression syndrome Cardiac mass   Increased afterload Aortic dissection Aortic valve stenosis Pathophysiology Obstruction of large vessels or heart Impaired diastolic filling Reduced cardiac preload Increased cardiac afterload Clinical presentations Non specific Presentation associated with underlying cause: cardiac mass , pneumothorax, etc Presentations of hypoperfusion: Tachycardia Hypo