sepsis + shock

Question 1

diagnosis SIRS

Answer 1

2 or more of: temp >38.5; HR>90; RR>20 or PaCO2>4.3; WBC >12 or

Question 2

diagnosis sepsis

Answer 2

evidence infection with 2 or more SIRS features

Question 3

diagnosis severe sepsis

Answer 3

sepsis alongside 1 or more signs of organ dysfunction: hypotension bp

Question 4

diagnosis septic shock

Answer 4

severe sepsis and acute circulatory failure despite adequate volume resus

Question 5

signs septic shock

Answer 5

bp 60, fall in syst BP >40, lactate >4

Question 6

sepsis 6

Answer 6

O2, fluids, antibios, lactace, urine output, cultures

Question 7

what % O2 and in COPD/type 2 failure

Answer 7

100% but in those with COPD/type 2 failure- start at 24% and titrate up

Question 8

broad spec abs - neutropenia

Answer 8

piperacillin/tazobactam- tazocin

Question 9

broad spec- resp

Answer 9

doxy, amox

Question 10

broad spec- GI

Answer 10

co amoxiclav

Question 11

broad spec cardio

Answer 11

benzlypenicillin

Question 12

broad spec CNS

Answer 12

ceftriaxone

Question 13

what do you risk when giving fluids

Answer 13

pulmonary and peripheral oedema

Question 14

what is lactate due to

Answer 14

hypoperfusion, hypoxia

Question 15

definition shock

Answer 15

acute circulatory failure with inadequate tissue perfusion results in hypoxia

Question 16

types of shock

Answer 16

hypovolaemic, cardiogenic, obstructive, distributive

Question 17

what is hypovolaemic due to

Answer 17

haemorrhage, burns

Question 18

features hypovolaemic

Answer 18

skin cold, pale, slow cap refill, anuria/oliguria, drowsy, confused, tachy, narrowed pulse pressure, sweating

Question 19

features cardiogenic

Answer 19

myocardial failure- incr JVP, pulsus alternans, gallop, basal crackles

Question 20

what can obstructive shock be due to

Answer 20

obstructed outflow- PE, restricted cardiac filling

Question 21

features obstructive shock

Answer 21

incr JVP, pulsus parodoxus, signs PE

Question 22

what is distributive shock

Answer 22

sepsis, anaphylaxis

Question 23

features sepsis, severe and septic shock

Answer 23

pyrexia and rigors, N&V, bounding pulse, hypotension, rapid cap refill