Sepsis And Septic Shock

Question 1

How is organ dysfunction defined?

Answer 1

Total SOFA score >/= 2 points from baseline

Question 2

What 3 things are needed for septic shock?

Answer 2

1. Sepsis
2. Vasopressors therapy needed to elevate MAP to >/= 65 mmHg
3. Lactate > 2 mmol/L

Question 3

What are the 3 most common areas of infection?

Answer 3

1. Pneumonia
2. Intra abdominal
3. Urinary

Question 4

SIRS are the ____ inflammatory mediators

Answer 4

Pro

Question 5

CARS are the ____ inflammatory mediators

Answer 5

Anti

Question 6

What causes type A hyperlactatemia?

Answer 6

Overproduction in ischemic tissue from a switch to anaerobic metabolism

Question 7

What causes type B lacatemia?

Answer 7

Decreased clearance of lactate

Question 8

What are the 6 assessments of the organ systems?

Answer 8

1. Glasgow coma scale
2. PaO2/FiO2 ratio
3. MAP
4. Serum creatinine
5. Platelets
6. T. Billi

Question 9

What is the goal for the use of fluids in sepsis?

Answer 9

Maximize cardiac output by increasing the left ventricular preload to increase perfusion

Question 10

What type of fluids are preferred for sepsis?

Answer 10

Crystalloids

Question 11

What is the initial fluid challenge for sepsis?

Answer 11

30 mL/kg within the first 3 hours

Question 12

What is the 1st line agent used for pressor support?

Answer 12

Norepinephrine

Question 13

What are the 2 second line agents used for sepsis?

Answer 13

1. Epinephrine
2. Vasopressin

Question 14

What are 2 third line agents for pressor support?

Answer 14

1. Dopamine
2. Phenylephrine

Question 15

True or false: steroids prevent septic patients from going into shock

Answer 15

False

Question 16

What steroid is used for septic shock?

Answer 16

Hydrocortisone 200 mg/day

Question 17

For adults with possible septic shock or a high likelihood for sepsis, when should antimicrobials be administered?

Answer 17

Within one hour of recognition

Question 18

For adults with possible sepsis without shock, when should antimicrobials be administered?

Answer 18

Within 3 hours from the time when sepsis was first recognized

Question 19

What vitamin should not be used?

Answer 19

Vitamin C