12.5 B

Question 1

The baseline mortality rate in the US for sepsis is what?

Answer 1

30-50 percent

Question 2

How many cases of sepsis are there each year in the US?

Answer 2

approximately 2 million

Question 3

How does a case of sepsis affect your long term health?

Answer 3

it puts you at greater risk of dying from stroke or MI and a number of other disease

Question 4

What trend has been seen in the incidence of sepsis over the last three decades?

Answer 4

population adjusted increase in incidence

Question 5

Which generation is sepsis most prevalent in?

Answer 5

baby boomers

Question 6

How many capillaries are there in the human body?

Answer 6

30-40 billion

Question 7

How many miles of blood vessels are there in the human body?

Answer 7

60,00 miles

Question 8

The biggest affect of sepsis on microcirculation is what?

Answer 8

that RBCs fail to deform in capillaries, limiting surface area for nutrient exchange and potentially clogging up the vessels

Question 9

Failure of RBCs to deform in sepsis causes what issues?

Answer 9

• clogs vessels
• limits nutrient exchange
• limits blood flow to tissue and triggers a switch to anaerobic metabolism

Question 10

What are the criteria for SIRS?

Answer 10

two or more of the following: abnormal temperature, tachycardia, tachypnea, elevated white cell count

Question 11

What are the criteria for sepsis?

Answer 11

SIRS + an infection

Question 12

What are the criteria for severe sepsis?

Answer 12

sepsis + organ dysfunction

Question 13

What are the criteria for septic shock?

Answer 13

sepsis + hypotension despite fluid resuscitation

Question 14

What are some indicators of organ dysfunction that might be seen in someone with severe sepsis?

Answer 14

• confusion/altered consciousness
• tachypnea
• hypotension
• oliguria, anuria, elevated creatine
• elevated bilirubin
• low platelet count

Question 15

What is procalcitonin?

Answer 15

a possible biomarker, not for diagnosis of sepsis but useful for follow up

Question 16

The most important thing about treating sepsis is what?

Answer 16

that it is done quickly

Question 17

What are the characteristics of “bundles of care?”

Answer 17

• combine multiple effective treatments
• outcome is additive or synergistic
• framework that leverages change
• avoids a piecemeal approach

Question 18

What should be done in the first three hours to treat sepsis?

Answer 18

• measure serum lactate
• obtain blood cultures
• administer broad spectrum antibiotics
• administer a 30mL/Kg bolus of fluid if hypotensive or has elevated lactate

Question 19

What should be done in the first six hours to treat sepsis?

Answer 19

• basically control blood pressure
• vasopressors if not responding to fluid
• measure cnetral venous pressure and central venous oxygen saturation
• remeasure lactate if initially elevated

Question 20

In the early resuscitation of severe sepsis, the most important treatment is what?

Answer 20

the administration of antibiotics