3.1 Acute sepsis

Question 1

What are the clinical features of SIRS?

Answer 1

Any 2 of:
Temperature below 36 or above 38
Heart rate above 90
Respiratory rate above 20
WBC count less than 4x10^9 or greater than 12x10^9

Question 2

What is bacteraemia?

Answer 2

Presence of bacteria in the blood

Question 3

What is septicaemia?

Answer 3

The clinical features of generalised sepsis

Question 4

What is classed as ‘severe sepsis’?

Answer 4

SIRS + organ dysfunction/hypo-perfusion

Question 5

What is septic shock?

Answer 5

Severe sepsis + persistently low blood pressure

Question 6

What are the inflammatory responses when:

i. ) Local
ii. ) Systemic
iii. ) SIRS

Answer 6

i. ) Cytokines act locally to stimulate inflammatory response
ii. ) Cytokines released into circulation to stimulate macrophage, GF and platelet release
iii. ) Circulatory insult and homeostasis lost

Question 7

What is the function of a cytokine?

Answer 7

Initiate production of thrombin

Inhibit fibrinolysis

Question 8

What investigations should be done to confirm sepsis?

Answer 8

Full blood count
Urea and electrolytes
Liver function tests
CRP
PCR of bacteria
Blood sugar

Question 9

What is the treatment for sepsis (the sepsis six)?

Answer 9

High flow of oxygen
Blood cultures
Empirical IV Antibiotics
Serum lactate measurements
IV fluids
Measure urine output

Question 10

List 3 complications of sepsis

Answer 10

Major hypotension
Acute kidney failure
Respiratory failure
Increased inter-cranial pressure
Ischaemic necrosis of extremities

Question 11

What is SIRS?

Answer 11

(Systemic Inflammatory Response Syndrome)

A response to a non-specific insult eg. trauma, infection