Picked up on ward rounds

Question 1

How much cortisol do we produce a day

Answer 1

5mg

Question 2

Why dont you stop steroid treatment immediately

Answer 2

As they have been on a high level of steroids they have suppressed their ACTH production and so adrenals will have stopped producing cortisol( as using exogenous steroids) for a long time so may have trouble starting again- weaning off allows adrenals to slowly start up again. RISK OF ADDISONIAN CRISIS

Question 3

Whats FiO2

Answer 3

Fraction of inspired oxygen- 20.9 in a room

Question 4

How to calculate FiO2

Answer 4

20+(4xLPM)

Question 5

What is compensated vs decompensated liver disease

Answer 5

Compensated means are showing no symptoms

Question 6

What is erythema

Answer 6

Redness of skin from increased blood flow- cause can be anything including infection

Question 7

What is an example of soft sign of sepsis

Answer 7

Diarrorhoea

Question 8

What is a serious problem associated with chemo

Answer 8

Risk of infection from lines when its making you immunocompromised already

Question 9

How would viral infection appear on FBC

Answer 9

CRP raised but normally above 50

WCC can be elevated or low

Question 10

Causes of low white blood cell count

Answer 10

Bone marrow
B12 or folate deficiency
Infection
Spleen problems
Autoimmune
Medicines like antibiotics

Question 11

What is sepsis

Answer 11

A life threatening organ dysfunction due to a dysregulated infection response

Question 12

What is SIRS

Answer 12

Severe inflammatory response syndrome

Question 13

What is criteria for diagnosing SIRS

Answer 13

`Temperature above 38 or below 36
HR above 90
RR above 20
PaCO2 above 32
Raised or lowered WCC

Question 14

What is qSOFA

Answer 14

New criteria for diagnosing sepsis

• SBP <100mmHg
• GCS 13 or below
• tachypnoea >22

Question 15

How is sepsis now diagnosed

Answer 15

Infection with qSOFA above 2

Question 16

How is septic shock now diagnosed

Answer 16

• Sepsis diagnosed
• need for vasopressors to maintain MAP above 65
• lactate above 2

Question 17

What is qSOFA formed from

Answer 17

SOFA was an old criteria used to diagnosed sepsis but judged to be way too complicated so introduced quick SOFA

Question 18

Acronym for qSOFA

Answer 18

Hypotensive
Attention
Tachypnoea

Question 19

Way to remember method for treating Sepsis

Answer 19

Sepsis 6 - give 3 and take 3

Question 20

What do you give with sepsis

Answer 20

O2
IV fluids
Antibiotics

Question 21

What to take when sepsis diagnosed

Answer 21

Blood cultures
VBG
Urine output

Question 22

What does broad spectrum antibiotics mean

Answer 22

they cover gram pos and neg

Question 23

What are 6 bacteria antibiotics cover

Answer 23

MRSA
Gram pos
Gram neg
Anaerobes
Pseudomonas
ESBL

Question 24

What does ESBL stand for

Answer 24

Extended spectrum beta lactamases

Question 25

Where do gram positive bacteria tend to infect

Answer 25

Chest
Skin
Soft tissue

Question 26

Where do gram negative bacteria tend to infect

Answer 26

UTI
Abdo
Biliary

Question 27

What do you generally divide gram positive bacteria into

Answer 27

Strep

Staph

Question 28

What do you tend to give for suspected strep infections

Answer 28

Penicillin

Question 29

What do you tend to give for suspected staph infections

Answer 29

Flucloxacillin

Question 30

What is ceftriaxone used for

Answer 30

gram neg and pos

Question 31

What is tazocin used for

Answer 31

everything except ESBL and MRSA

Question 32

What is co-amoxiclav used for

Answer 32

gram pos
gram neg
anaerobes

Question 33

what would you use for suspected pseudomonas

Answer 33

neuropenem

tazocin