Sepsis

Question 1

What is sepsis?

Answer 1

Life threatening organ dysfunction caused by a dysregulated host response to infection

Question 2

What is septic shock?

Answer 2

A more severe form of sepsis which occurs when the BP drops despite fluid resus. It is diagnosed with:
- A low MABP below 65mmHg: may require escilation for vasopressors
- Raised serum lactate above 2mmol/L

Question 3

What is the qSOFA score?

Answer 3

Respiratory rate > 22/min
Altered mentation
Systolic blood pressure < 100mmhg

Question 4

What are the risk factors for sepsis

Answer 4

• Extreme ages,
• Chronic conditions,
• Chemotherapy/immunosuppressants or steroids
• Surgery, recent trauma or burns,
• Pregnancy and childbirth
• Indwelling medical devices

Question 5

What is the presentation of sepsis?

Answer 5

• High HR, low BP, high RR, low O2 sats
• Signs of potential source eg, cellulitis, discharge
• Reduced urine output
• Mottled skin,
• Cyanosis,
• Arrhythmias such as new onset AF,
• Non blanching rash seen in meningococcal septicaemia

Question 6

What are the investigations for sepsis?

Answer 6

• Sepsis 6,
• Bloods: FBC, U&Es, LFTs, CRP, glucose, clotting, blood cultures,
• ABG

Question 7

Explain the sepsis 6

Answer 7

• Take blood cultures
• Start broad spectrum antibiotics
• Measure serum lactate
• Measure Urine output
• Give oxygen
• Give IV fluids

Question 8

What is neutropenic sepsis?

Answer 8

Sepsis in someone with a neutrophil count below 1. Anyone on chemotherapy with a temp > 38 is neutropaenic sepsis until proven otherwise

Question 9

Name some medications which can cause neutropenia

Answer 9

• Chemotherapy,
• Clozapine,
• Hydroxychloroquine
• Methotrexate,
• Sulfasalazine,
• Carbimazole,
• Quinine
• Infliximab,
• Rituximab

Question 10

What is the management of neutropenic sepsis?

Answer 10

Immediate broad spectrum abx such as tazocin