Sepsis

Question 1

What is the cause of sepsis?

Answer 1

systemic illness caused by microbial invasion of normally sterile parts of the body.

Question 2

What is the difference between sepsis and septic shock?

Answer 2

sepsis - life threatening organ dysfunction caused by a dysregulated host response to an infection
Septic shock - this is sepsis but with persistent hypotension

Question 3

What is the qSOFA?

Answer 3

• Hypotension (systolic BP <100mmHG)
• Altered mental status
• Tachypnoea (RR>22/min)

Score of 2 or above = poor outcome.

Question 4

What is the mortality rate for septic shock?

Answer 4

Increases by 7.6% every hour antibiotics aren’t given.

Question 5

What are the 3 phases of pathogenesis in sepsis?

Answer 5

• release of bacterial toxins
• release of mediators
• effect of specific excessive mediators

Question 6

What is Th1 and Th2?

Answer 6

Th1 - pro-inflammatory mediators (cause the inflammatory response that is seen in sepsis)
Th2 - anti-inflammatory reaction (can cause lack of immune response)

^there must be a fine balance to prevent sepsis or lack of immune reaction.

Question 7

What are the main features of sepsis?

Answer 7

• Fever >38 degrees
• hypothermia - if old, young or immunosuppressed
• tachycardia > 90 BPM
• tachypnoea >20/min
• altered mental status
• hyperglycaemia >8mml

Question 8

Why do some people develop a fever and some don’t?

Answer 8

Immune competent people develop a fever, immune compromised don’t.

Question 9

What is the sepsis 6?

Answer 9

Take 3:
blood culture
blood lactate
urine output

Give 3:
IV fluids
Oxygen (94-98%, 88-92% in COPD)
broad spectrum antibiotics

Question 10

What is neutropenic sepsis?

Answer 10

Patients with a fever of >38 or features of sepsis with a neutrophil count of <0.5x 10^9

should also be treated with sepsis 6

Question 11

What are common broad spectrum antibiotics?

Answer 11

Piperacillin with tazobactam