Sepsis

Question 1

What is septic shock?

Answer 1

• sepsis

- hypotension despite fluid resuscitation

Question 2

What is severe sepsis?

Answer 2

-sepsis with organ dysfunction

Question 3

What is systemic inflammatory response syndrome (SIRS)?

Answer 3

-a clinical response arising from an insult manifested by 2 or more of the following:

• temp > 38
• HR > 90bpm
• Respirations > 20
• WBC >12,000 or

Question 4

What bacteria are the most common cause of sepsis?

Answer 4

• E. coli

- S. aureus

Question 5

What is the most common site of infection which leads to severe sepsis?

Answer 5

-lung

Question 6

What is the most common site of infection which leads to severe sepsis?

Answer 6

-lung

Question 7

What is the “toxic” portion of LPS?

Answer 7

Lipid A

Question 8

What are the 2 main cytokines released by monocytes that lead to sepsis?

Answer 8

• TNF-a = shock

- Tissue Factor (TF) = coagulation

Question 9

What is a PAMP?

Answer 9

=Pathogen-associated molecular pattern

-bind to TLRs

Question 10

Each of the following is a PAMP except:

A.  LPS
B.  Glycogen
C.  Unmethylated CpG DNA
D.  Mannan
E. Peptidoglycan

Answer 10

B. Glycogen

Question 11

Each of the following is a PAMP except:

A.  LPS
B.  Glycogen
C.  Unmethylated CpG DNA
D.  Mannan
E. Peptidoglycan

Answer 11

B. Glycogen

Question 12

Which of the statements below is NOT true?

A. Infection + SIRS ( ≥ 2 criteria) = Sepsis
B. Sepsis + Organ Dysfunction (one or more organ) = Severe Sepsis
C. Multiorgan dysfunction syndrome is dysfunction of more than one organ always in the setting of infection
D. Septic shock is a subset of severe sepsis involving the cardiovascular system

Answer 12

C. Multiorgan dysfunction syndrome is dysfunction of more than one organ always in the setting of infection

Question 13

What kind of sepsis leads to Purpura fulminans?

Answer 13

meningococcal sepsis

Question 14

Which is the most frequent lab abnormality in Disseminated Intravascular Coagulation ?

A. Thrombocytopenia
B. Inc. PT (prothrombin time)
C. Inc. PTT (partial thromboplastin time)
D. Inc. D-dimers or fibrin split products
E. Dec. Fibrinogen

Answer 14

D. Inc. D-dimers or fibrin split products

Question 15

Which is the most frequent lab abnormality in Disseminated Intravascular Coagulation ?

A. Thrombocytopenia
B. Inc. PT (prothrombin time)
C. Inc. PTT (partial thromboplastin time)
D. Inc. D-dimers or fibrin split products
E. Dec. Fibrinogen

Answer 15

D. Inc. D-dimers or fibrin split products

Question 16

Which of the statements about standard treatments for sepsis is NOT true?

A. Control the source of infection
B. Administer appropriate antibiotics AFTER cultures obtained and within three hour of recognition of severe sepsis
C. Use colloid-containing solutions for volume replacement
D. Use norepinephrine for hemodynamic support
E. Target a tidal volume of 6 ml/kg in patients with ALI/ARDS

Answer 16

C. Use colloid-containing solutions for volume replacement

Question 17

Which of the statements about standard treatments for sepsis is NOT true?

A. Control the source of infection
B. Administer appropriate antibiotics AFTER cultures obtained and within three hour of recognition of severe sepsis
C. Use colloid-containing solutions for volume replacement
D. Use norepinephrine for hemodynamic support
E. Target a tidal volume of 6 ml/kg in patients with ALI/ARDS

Answer 17

C. Use colloid-containing solutions for volume replacement

Question 18

________ supplementation in patients with refractory septic shock may be beneficial.

Answer 18

Steroid

Question 19

Inflammation and ________ are tightly linked in sepsis especially via mononuclear phagocytes.

Answer 19

coagulation