READ ME / 1: Introduction to sepsis

Question 1

Thanks for using my flashcards, hope you find them useful!

If you spot any errors or have suggestions, please let me know by clicking the speech bubble or sending me a message. It’s really helpful.

Question 2

The questions are written using the official Dundee lectures, so you might find it useful to have them open in the background in case you get stuck.

Question 3

I write the questions based on what I think the important facts are, but not everything is relevant. Don’t waste your time learning tiny details.

Question 4

On the other hand, this isn’t everything you need to know - back it up with stuff from tutorials, other people’s questions, Youtube videos, Oxford handbooks etc.

Question 5

There’s a good chance that older decks will be inaccurate (lectures and guidelines change year to year) so I’ll try to update them in the future.

Break a leg 👍

Question 6

What should be eliminated in any patient with an infection?

Answer 6

Sepsis

Question 7

What does colonisation mean?

Answer 7

Microbe in the body WITHOUT an inflammatory response

e.g Staph aureus on the skin

Question 8

What is infection?

Answer 8

Inflammatory response due to a microbe

Question 9

What is bacteraemia?

Answer 9

Presence of viable bacteria in the blood

Question 10

What is septicaemia?

Answer 10

A duff term that shouldn’t be used

Question 11

What is the definition of sepsis?

Answer 11

Life-threatening organ dysfunction caused by dysregulated host response to infection

Question 12

What is the definition of septic shock?

Answer 12

Circulatory / metabolic dysfunction secondary to sepsis

i.e the patient cannot be adequately resuscitated

Question 13

___ is a subset of ___.

(sepsis, septic shock)

Answer 13

Septic shock is a subset of sepsis

Question 14

People with septic shock have a much higher mortality and should be admitted to…

Answer 14

intensive care

Question 15

Sepsis has distinct ___ and ___.

Answer 15

signs and symptoms

Question 16

What is an abdominal infection caused by leakage of bowel contents into the peritoneal cavity?

Answer 16

Peritonitis

Question 17

general signs and symptoms of sepsis

Question 18

What needs to be determined re: sepsis to treat it properly?

Answer 18

Severity

Question 19

How does sepsis cause organ dysfunction?

Answer 19

Bacteraemia causes leaky blood vessels

> ischaemia, infarction

Question 20

What is SIRS?

Is it in favour anymore?

Answer 20

Systemic inflammatory response syndrome

No, NEWS or qSOFA criteria used now

Question 21

Is SIRS specific to infection?

Answer 21

No, caused by trauma, pancreatitis…

But all patients with sepsis fulfill the SIRS criteria

Question 22

Apart from infection, what are some other causes of SIRS?

Answer 22

Trauma (especially polytrauma)

Burns

Pancreatitis

Question 23

What are the SIRS criteria?

Answer 23

T > 38 or < 36

HR > 90bpm due to leaky vessels > insufficient perfusion

RR > 20/min due to perceived hypoxia

Raised or reduced WBCs

Question 24

With regard to SIRS criteria, what is sepsis?

Answer 24

2+ fulfilled SIRS criteria with KNOWN INFECTION

Question 25

What is septic shock with regard to SIRS criteria?

Answer 25

2+ fulfilled SIRS criteria

Known infection

Organ dysfunction

Hypotension despite fluid resuscitation

Question 26

As sepsis progresses to septic shock, mortality ___.

Answer 26

increases

Question 27

How do you remember the Sepsis 6 bundle of treatment?

Answer 27

BUFALO

Give three, take three

(Take blood, urine output, lactate. Give fluids, oxygen and antibiotics.)

Question 28

What is SOFA?

Answer 28

Sequential organ function assessment

A scoring system for sepsis

Question 29

When is the actual SOFA score used?

Answer 29

ICU

when you have access to loads of information

Question 30

What is the abbreviated version of the SOFA score?

Answer 30

qSOFA

Question 31

What are the three criteria in the qSOFA score?

Answer 31

RR > 22/min

sBP < 100mgHg

Altered GCS

Question 32

The higher your qSOFA score, the greater your ___.

Answer 32

mortality

Question 33

qSOFA:

Respiratory rate > __ / min

sBP < ___ mmHg

GCS < __

Answer 33

RR > 20/min

sBP < 100 mmHg

GCS < 14

Question 34

How does the NHS score patients at risk of sepsis?

Answer 34

NEWS2 score

Question 35

A NEWS2 score of > __ and __ is diagnostic of sepsis.

Answer 35

NEWS2 > 5

confirmed infection

Question 36

The higher your NEWS2 score, the poorer your ___.

Answer 36

prognosis

Question 37

NEWS2 and ___ scoring tend to agree with one another.

Answer 37

qSOFA