Sepsis & Endocarditis

Question 1

What is the most likely organism leading to infective endocarditis?

Answer 1

S. aureus

Question 2

Why is infective endocarditis so dangerous?

Answer 2

• Bacterial vegetations along heart (valves)
• 50% of pts need surgery to remove vegetations
• may need prosthetic valve & cardiac devices post-infection

Question 3

If a patient is using {{BLANK}} drugs they are more likely to suffer from infective endocarditis

Answer 3

Inj. drugs

Question 4

Infective endocarditis is most assoc. w/ which cardiac factors?

Answer 4

• Intracardiac device
• Prosthetic valve

Most have no known cause

Question 5

2/3 of infective endocarditis cases worldwide remain associated with {{BLANK}} due to PCN-sensitive Streptococci spp.

Answer 5

Rheumatic fever

Question 6

What is the diff. between possible infective endocarditis and definite?

According to the DUKE criteria

Answer 6

• Possible: positive PE findings (e.g., Roth spots & Osler’s nodes)
• Definite: positive vegetation, blood culture, or ECHO

Question 7

What is the qSOFA criteria?

Answer 7

• RR ≥ 22
• Altered cognition
• Systolic BP ≤ 100

Question 8

Interpret the qSOFA results for: 0-1, 2, and 3

Answer 8

• 0-1: 1-2% mortality
• 2: 8% mortality
• 3: > 20% mortality

2 & 3 = high-risk

Question 9

What is the most common pathogen leading to sepsis in adult ICUs?

Answer 9

Candida spp.

Question 10

What are the most likely bacterial pathogens leading to sepsis?

Answer 10

• S. aureus (20.7%)
• E. coli (20.5%)

Question 11

What are the common infections that lead to sepsis?

Answer 11

• Lung (35%)
• UTI (25%)
• GIT (11%)
• Skin (11%)

Question 12

What is the rough mortality rate (overall) of sepsis? What about septic shock?

Even if responds to ABx

Answer 12

• Sepsis: 30-50%
• Septic shock: 80%

Question 13

{{BLANK}} is a life-threatening organ dysfunction caused by dysregulated host response to infection

Answer 13

Sepsis

Question 14

Septic shock needs treated with a {{BLANK}} to maintain MAP > 65 mmHg & serum lactate level > 2 mmol/L

Answer 14

Vasopressor

Question 15

What is the SIRS criteria?

Answer 15

• Temp: > 38C (100.4F) or < 36C (96.8F)
• HR > 90 bpm
• RR > 20 or PaCO2 < 32
• WBC > 12,000 or < 4,000 or > 10% bands