peds sepsis

Question 1

how to know when you have shifted from colonization to infection?

Answer 1

infxn characterized by inflammatory response

Question 2

signs of an inflammatoyr response (5)

Answer 2

calor, rubor, tumor (swelling), dolor, functio laeso

Question 3

evidence of inflammatory response includes increased ___(4)

Answer 3

1. WBC
2. CRP
3. ESR
   4, Procalcitonin

Question 4

definition of fever

Answer 4

> 100.4 (38)

Question 5

body temp is ____in the AM, and ___in the evening

Answer 5

lowest; highest

Question 6

what type of temperature reading is the gold standard

Answer 6

rectal

Question 7

SIRS criteria: temp

Answer 7

> 38, under 36

Question 8

SIRS criteria: HR

Answer 8

> 90 or 2 SD above mean for age

Question 9

SIRS criteria: RR

Answer 9

> 30 or 2 SD above mean for age

Question 10

SIRS criteria: PaCO2

Answer 10

under 32

Question 11

SIRS criteria: WBC

Answer 11

> 15K, under 5K; bands >10%

Question 12

SIRS in the absence of identifiable ifnxn is called?

Answer 12

SIRS

Question 13

SIRS with infxn is called?

Answer 13

sepsis

Question 14

sepsis assc’d with organ dysfunction is called?

Answer 14

severe sepsis

Question 15

sepsis that persists after adequate fluid resuscitation

Answer 15

septic shock

Question 16

the presence of altered organ fxn in acutely ill patient so that physiologic homeostasis cannot be maintained without intervention

Answer 16

MODS

Question 17

what does MODS stand for?

Answer 17

multi organ dysfxn syndrome

Question 18

newborn BP normal

Answer 18

66/41

Question 19

normal newborn HR

Answer 19

120-150

Question 20

normal newborn RR

Answer 20

40-60

Question 21

sepsis that occurs in the first 6 days of life

Answer 21

early onset sepsis

Question 22

most common pathogens acquired from mothers GU tract

Answer 22

GBS, e coli, listeria

Question 23

factors that incr risk for early onset sepsis (6)

Answer 23

1. prolonged rupture of membrane
2. maternal chorioamnionitis
3. maternal fever during labor
4. previous infant with GBS
5. mother under 20 yo
6. premies

Question 24

inflammation of fetal membranes

Answer 24

chorioamnionitis

Question 25

how does chorioamnionitis present? fever during labor +_______

Answer 25

2 of the following: fetal tachycardia, uterine tenderness, fould vaginal discharge, maternal leukocytosis

Question 26

late onset sepsis occurs in an infant greater than ___to ___

Answer 26

3 days to 90 days

Question 27

how is late onset sepsis most commonly acquired?

Answer 27

patient’s caregiving environment

Question 28

is early or late onset more likely to present with meningitis?

Answer 28

late onset

Question 29

is early or late onset more likely to present with pneumonia?

Answer 29

early onset

Question 30

how to tx early onset disease?

Answer 30

Amp + aminoglycoside or 2nd gen cephalosporin

Question 31

how to tx late onset disease?

Answer 31

2nd/3rd gen ceph +/- vancomycin

Question 32

well appearing kid with bacteremia & without clinical evidence of sepsis

Answer 32

occult bacteremia

Question 33

The most common cause of occult bacteremia is

Answer 33

strept pneumo

Question 34

tx of occult bacteremia

Answer 34

1. get blood culture, IM ceftriaxone OR

2. get WBC count, blood culture, give ceftriaxone

Question 35

presence of neisseria meningitidis in the bloodq

Answer 35

meningococcemia

Question 36

presents with fever, petechia, hypotension, lethargy, emesis

Answer 36

meningococcemia

Question 37

highest attack rates of meningococcemia

Answer 37

6 month-1 year

Question 38

dx of neisseria meningitidis?

Answer 38

rapid latex agglutination on CSF, or can test blood

Question 39

how to tx meningococcemia

Answer 39

PCN G