Septic Shock

Question 1

Less than 90 mmHg systolic, a reduction of SBP of 40 mmHg or evidence of Hypo-perfusion is referred to as?

Answer 1

Hypotension

Question 2

MAP stands for what?

Answer 2

Mean arterial pressure (MAP=SBP+2(DBP)/3

Question 3

What 8 differential diagnosis of shock/hypotension?

Answer 3

Endocrine
Neurogenic (anaphylactic)
Drugs (distributive)
Septic (infection)
Hypovolemia
Overdose (obstruction)
Cardiogenic
Kills

Question 4

Worldwide, ____% of sepsis is caused by gram negative ______% by gram positive and ___% fungal

Answer 4

62, 47, 19

*adds up to more than 100%….

Question 5

The clinical syndrome that results from a dysregulated inflammatory response to infection presenting with hypotension is called what?

Answer 5

Septic Shock

Question 6

What are the two types of organ dysfunction?

Answer 6

1-Primary (result of well defined insult)

2-Secondary (not due to infection itself, but to the hosts response)

Question 7

What are three mechanisms of tissue injury?

Answer 7

1-Ischemia (decreased O2 in tissue)
2-Cytopathic injury (inflammatory mediators cause damage)
3-Increased apoptosis

Question 8

Lactate levels are often measured in sepsis, what are the two mechanisms that lead to high levels?

Answer 8

1-Hypoxic- anaerobic production of lactate
2-Non-hypoxic- decreased clearance of lactate

*survival is 10

Question 9

What three things are part of the 6 hour resuscitation bundle?

Answer 9

1-Early identification
2-Early antibiotics and cultures
3-Early goal directed therapy

Question 10

What are 7 sepsis agents that have failed to date?

Answer 10

1-Endotoxin modifiers
2-Cytokine modifiers
3-Immune suppression
4-PAF modifiers
5-Nitric Oxide Modifiers
6-Eicosanoids modifier
7-Coagulation modifier

Question 11

What are the 4 Systemic Inflammatory Response Syndrome (SIRS) criteria?

Answer 11

1-Temperature >38C (100.4) or 90bpm
3-Respiratory Rate >20rpm
4-WBC >12,000 K/ul or 10% bands