3/2/17 Septic Shock HARRIS TEST #2

Question 1

What are the four criteria you look for in systemic inflammatory response? (SIRS) (you have to have at least two of these if sepsis is considered)

Answer 1

• Temperature
• Heart Rate
• Respiratory Rate
• WBC

Question 2

If you have an inflammatory response to microorganisms or the invasion of normally sterile tissues what do you have?

Answer 2

-Infection

Question 3

If you have a systemic response to a variety of processes what might you have?

Answer 3

-SIRS

Question 4

If you have an infection plus 2 SIRS criteria what might you have?

Answer 4

-Sepsis

Question 5

If you have sepsis with organ dysfunction what might you have?

Answer 5

-Sever sepsis

Question 6

If you have sepsis with hypotension despite fluid resuscitation what might you have?

Answer 6

-Septic shock

Question 7

Who can get sepsis?

Answer 7

-Anyone

Question 8

T/F Sepsis is most often present with pre-existing diseases such as cirrhosis, malignancy, AIDS, COPD, diabetes, and cancer therapy.

Answer 8

True

Question 9

What gram species historically was more common at causing sepsis?

Answer 9

-Gram -

Question 10

What gram species between 1979-2000 in the US at causing sepsis?

Answer 10

-Gram +

Question 11

Today worldwide what is the most common gram species at causing sepsis?

Answer 11

-Gram -

Question 12

What is Hypotension in blood pressure readings?

Answer 12

< 90 mmHg systolic

Question 13

When you think of the differential diagnosis of shock/hypotension what other things do you have to take into consideration?

Answer 13

• Endocrine
• Neurogenic, anaphylactic
• Drugs, distributive
• Septic
• Hypovolemia
• Overdose, obstruction
• Cardiogenic
• Kills

Question 14

What is sepsis?

Answer 14

-Clinical syndrome that results from a dysregulated inflammatory response to infection

Question 15

If a patient has continued hypotension after a fluid bolus (usually 10-30 ml/kg) what could that be a sign of?

Answer 15

-Septic shock

Question 16

What is hypotension often associated with?

Answer 16

-Organ damage or dysfunction

Question 17

What is primary organ dysfunction?

Answer 17

-Result of a well-define insult (renal failure from muscle breakdown products)

Question 18

What is secondary organ dysfunction?

Answer 18

-Not due to infection itself, but due to the host’s response (possibly a dysregulation of the innate immune system)

Question 19

What are three mechanisms of tissue injury?

Answer 19

• Ischemia
• Cytopathic injury
• Increased apoptosis

Question 20

What type of tissue injury mechanisms is when inflammatory mediators cause damage (direct and indirect)?

Answer 20

-Cytopathic injury

Question 21

What is ischemia?

Answer 21

-Decreased O2 given tissue needs

Question 22

What does PIRO stand for?

Answer 22

• Predisposition
• Insult
• Response
• Organ Dysfunction

Question 23

When you treat Sepsis what should you do for a prophylaxis?

Answer 23

• ICU prophylaxis
• Nutrition
• PT

Question 24

What is the goal in the treatment of sepsis?

Answer 24

-Restore tissue perfusion

Question 25

What are three things to do in the 6 hour resuscitation bundle of sepsis?

Answer 25

• Early identification
• Early antibiotics and cultures
• Early goal directed therapy

Question 26

What is the historic survival if the lactate is > 10?

Answer 26

< 10%

Question 27

T/F When someone has Sepsis it is extremely important to monitor tissue perfusion

Answer 27

True

Question 28

If your body temperature is above what it may be an indication of sepsis

Answer 28

101 F

Question 29

If your body temperature below what it may be an indication of sepsis?

Answer 29

-96.8 F