26- Sepsis

Question 1

sepsis is due to

Answer 1

disregulated inflammatory response to infection

Question 2

define septic shock

Answer 2

is sepsis that has a circulatory, cellular and metabolic abnormalities associated greater risk of mortality than sepsis alone

Question 3

critera for sepsis

Answer 3

despite adequate fluid resuscitation, require vasopressors to maintain a mean arterial pressure >65 mmHg and have a lactate of >2 mmol

Question 4

T/F about 80% of hospital treated sepsis arise in the community

Answer 4

T

Question 5

most common site of infection that leads to sepsis is

Answer 5

• lung (64%)
• abdomen (20%)
• bloodstream (15%)
• renal and genitourinary (14%)

Question 6

T/F thereis almost equal prevalence of gram pos and gram nag bacterial infections in pts with sepsis

Answer 6

T

• gram pos: s aureau
• gram neg: Pseudomanas, E coli

Question 7

SOFA score

Answer 7

sequential organ failure assessment

• used in ICE to predict in hospital mortality in critical pts
• PaO2/FIO2; coagulation platelets; bilirubin; hypotension; GCS; creatinine/urine output

Question 8

q SOFA is

Answer 8

THIS IS NOT FOR RULING OUT PTS PTS
based on 3 things (high risk if 2 criteria)
- alteration in mental status
- systolic blood pressure <100 mmHg
- respiratory rate >22 bpm

Question 9

mx of sepsis

Answer 9

1 hour bundle

• initial fluid resuscitation
• antibiotic tx
• source control
• vasoactive

Question 10

poor prognostic factors for sepsis

Answer 10

• inability to mount a fever
• leukopenia
• > 40 age
• comorbidities (AIDS, hepatic failure, cirrhosis, cancer, alcohol dependance, immunosuppression)
• non urinary infection
• nosocomial source of infection
• late/wrong antibiotic coverage

Question 11

serum lactate level in septic shock

Answer 11

> =4mmol/L