Wk 1 Sepsis and Shock

Question 1

What is sepsis?

Answer 1

A syndrome of life-threatening organ dysfunction caused by a dysregulated host response to infection
=infection + organ failure

Question 2

How is organ failure defined?

Answer 2

1. Pulmonary - hypoxia
2. Neurologic - altered mental status, delerium, Glascow coma score
3. Hematologic - cytopenias
4. Hepatic -
5. Renal - decreased urine output, later increased creatinine (delayed 12-24 hrs)
6. Cardiovascular - most worrisome - low BP, perfusion, elevated troponin, echocardiography, US

Question 3

Shock

Answer 3

Systemic tissue hypoperfusion

Question 4

What is septic shock?

Answer 4

Systemic tissue hypoperfusion despite IV fluid resuscitation in the setting of infection

Question 5

Clinical indicators of shock

Answer 5

1. Hypotension
2. Serum lactate levels due to cellular ischemia and transition to anaerobic glycolysis
3. End-organ dysfunction - encephalopathy, oliguria

Question 6

3 physiologic causes of shock

Answer 6

1. Distributive- inadequate vascular tone - vessels can’t squeeze
2. Cardiogenic - inadequate forward stroke volume - heart can’t squeeze or squeeze is blocked or diverted
3. Hypovolemic - inadequate preload - nothing to squeeze

Question 7

3 physiologic causes of shock

Answer 7

1. Distributive- inadequate vascular tone - vessels can’t squeeze
2. Cardiogenic - inadequate forward stroke volume - heart can’t squeeze or squeeze is blocked or diverted
3. Hypovolemic - inadequate preload - nothing to squeeze

Question 8

Classifications of physiologic causes of shock

Answer 8

Question 9

What is SIRS?

Answer 9

=systemic inflammatory response syndrome
defined by abnormalities in ≥2 or more of:

Question 10

Pathogenesis of sepsis

Answer 10

Activation of complement and coagulation proteases