Sepsis

Question 1

Systemic inflammatory response syndrome (SIRS)must have \_\_\_ of the following:
Temp  \_\_\_ C
Pulse > \_\_\_ bpm
Respiratory rate >\_\_\_ /min or PaCO2 \_\_\_\_
WBC \_\_\_\_

Answer 1

Systemic inflammatory response must have 2 of the following:
Temp 35 C or >38 C (hypo or hyperthermia)
Pulse > 90 bpm
Respiratory rate > 20/min or PaCO2 less than 35 mmHg
WBC less than 4000 or greater than 12,000/mm3 or band forms > 10%

Question 2

Severe sepsis = sepsis + ___, ____ or ___.
Capillary refill > ___
Urine output:
Platelet count:

Answer 2

hypoperfusion,hypotension orfailure of at least one organ or organ
Capillary refill > 3s
Urine output less than 0.5 ml/kg/hr
Platelet count: less than 100,000 cells/uL

Also:
Elevated lactate
Abrupt altered mental status
Acute lung injury
Cardiac dysfunction

Question 3

Septic shock= severe sepsis + ___ of the following EXCEPT:
A. Ongoing hypotension despite volume resuscitation
B. Need for vasopressors to maintain BP
C. Widespread edema

Answer 3

C

Question 4

Inflammatory response that is abnormal in space and time =

Answer 4

sepsis

Question 5

T/F: Failed organs in sepsis typically have grossly abnormal histories that’s helpful in diagnosis.

Answer 5

False. Grossly normal history

Question 6

Name the 4 processes that accounts for observations of organ failure

Answer 6

O2 utilization/metabolism
Cagulopathy
Programmed cell death
Hypoperfusion

Question 7

All of the following are characteristics ofwarm shockEXCEPT:
A. Capillary refill less than 3 s
 B. ScvO2 low
C. Bounding pulse
D. CO compensated by decreased PVR

Answer 7

B. ScvO2 high in warm shock

ScvO2 low in cold shock.
Cold shock also has delayed capillary refill, weak pulses

Question 8

T/F:Mortality rises ~15-20% for each failing organ system.

Answer 8

True

Question 9

Management of sepsis (2)

Answer 9

Treat infection appropriately immediately

Institute resuscitation to optimize tissue profusion immeditately