Sepsis part 1

Question 1

What is the definition sepsis?

Answer 1

Life threatening organ dysfunction due to a dysregulated host response to infection

Question 2

What triggers sepsis?

Answer 2

Infection (in susceptible patients)

Question 3

What is sepsis?

Answer 3

Overwhelming immune response (to infection) that causes organ dysfunction

Question 4

What differentiates sepsis from infection?

Answer 4

Presence of organ dysfunction

Question 5

What is the definition of septic shock?

Answer 5

Sepsis in which the underlying circulatory and cellular and/or metabolic abnormalities are marked enough to substantially increase mortality

Question 6

How is septic shock clinically defined?

Answer 6

Persisting hypotension that requires vasopressors to maintain mean arterial pressure at > or = 65mmHg and with a serum lactate concentration > 2mmol/L

Question 7

How can organ dysfunction Be identified?

Answer 7

SOFA score of > or = 2 points

Question 8

What does SOFA stand for?

Answer 8

Sequential Organ Failure Assessment

Question 9

What is qSOFA used for?

Answer 9

A tool to clinically characterise patients at risk of sepsis (at risk of prolonged ICU or death)

Question 10

What are the 3 main criteria to look for in qSOFA?

Answer 10

1. Respiratory breaths > or = 22 breaths/min
2. Altered mentation (Glasgow coma scale <15)
3. Systolic blood pressure < or = 100mmHg

Question 11

What should the baseline value of qSOFA be in a patient?

Answer 11

0 unless patient has pre-existing organ dysfunction before onset of infection

Question 12

List 4 sites of infection that can trigger sepsis from most to least likely?

Answer 12

1. lungs(64%)
2. Abdomen (20%)
3. Bloodstream (15%)
4. Urinary system (14%)

More than 100% as some patients have multiple infections

Question 13

What are the SOURCES of infection that have the highest likelyhoods of causing sepsis?

Answer 13

1. gram positive bacteria (47%)
   - staph aureus
2. Gram negative bacteria (62%)
3. Fungal (19%)
   - Candida (17%)

Question 14

What infection is associated with a higher ICU mortality compared to bacterial infections?

Answer 14

Candida bloodstream infection

Question 15

Who typically gets sepsis?

Answer 15

.Most common among ageing population
- 65% of cases in US

. Sepsis disproportionately affects medically immune-compromised patients

• cancer
• cirrhosis
• autoimmunity
• HIV/AIDS
• organ transplantation
• diabetes