B3-002 Sepsis

Question 1

Systemic Inflammatory Response Syndrome (SIRS)

Answer 1

Cytokine storm with many causes, not just infection.

Question 2

SIRS Criteria

Answer 2

2/4
Fever or hypothermia
Tachycardia
Tachypnea
Leukocyte Abnormality

Question 3

Early Sepsis

Answer 3

No formal definition.
Infection and bacteremia - increase risk for developing sepsis.
Identification is key to prevent morbidity and mortality.
Predictive, not diagnostic.

Question 4

Early Sepsis Criteria

Answer 4

Respiratory rate >22
Altered mentation
Systolic blood pressure <100

Question 5

Sepsis

Answer 5

Life threatening organ dysfunction CAUSED BY AN INFECTION with a dysregulated host response.
SOFA score increase of 2+

Question 6

Shock

Answer 6

Diminished cardiac output or reduced effective circulating blood volume impairs tissue perfusion and leads to cellular hypoxia.
Can be reversible if treated early.
Can be fatal.
Caused by infection, anaphylaxis, cardiac abnormalities, hypovolemia (decrease in circulating blood volume).

Question 7

Cytokine

Answer 7

Soluble proteins that interact with cells to produce changes in growth/activation of immune cells, inflammation, and the immune response

Question 8

Multiple Organ Dysfunction Syndrome

Answer 8

Progressive.
More organs involved = higher mortality.
Primary: result of a defined insult
Secondary: results of an indirect insult due to host response.
No universal criteria - use SOFA score

Question 9

SOFA Score

Answer 9

Assesses end organ dysfunction in patients with sepsis
Not diagnostic.
Doesn’t indicate infection is the cause, nor determine treatment strategies.
Does help to identify patients at high risk for mortality from infection

Question 10

Stages of Shock

Answer 10

1. Non-progressive: reversible, compensatory mechanisms allow for survival
2. Progressive: failing compensatory mechanisms, increasing tissue hypoxia, beginning lactic acidosis due to tissue anaerobic metabolism
3. Irreversible: leads to death

Question 11

Lactic Acidosis

Answer 11

During progressive shock stages, tissue hypoxia increases, beginning lactic acidosis doe to tissue anaerobic metabolism.

Question 12

Disseminated Intravascular Coagulation

Answer 12

Serious sign of end stage sepsis
Activation of clotting cascade within the vascular compartment from tissue injury, endothelial damage, or both
Produces a non-blanching rash (Petechiae)

Question 13

Rubor

Answer 13

Redness

Question 14

Calor

Answer 14

Heat

Question 15

Tumor

Answer 15

Swelling

Question 16

Dolor

Answer 16

Pain

Question 17

Finctio Laesa

Answer 17

Loss of function

Question 18

Broad Spectrum Antobiotics

Answer 18

Should be used for “mixed” infections, or when pathogen identity and sensitivities are not know.
Maximizes probability of toxicity to pathogen(s)

Question 19

Stages of Shock

Answer 19

1. Non-progressive: reversible, compensatory mechanisms allow for survival
2. Progressive: failing compensatory mechanisms, increasing tissue hypoxia, beginning lactic acidosis due to tissue anaerobic metabolism
3. Irreversible: leads to death