SEPSIS

Question 1

3 main features of sepsis syndrome

Answer 1

1. Microbial invasion of sterile sites
2. Systemic inflammatory response
3. Organ damage

Question 2

Specific feature of meningococcal sepsis

Answer 2

Rash that doesnt fade under pressure, i.e. capillary bleeding

Question 3

Evidence markers of systemic inflammatory response

Answer 3

2+ of:

• Temp >38 or <36
• HR> 90/min
• RR> 20/min
• WBC > 12x10⁶/ml or <4x10⁶

SIRS criteria are not specific for infection organ dysfunction

Question 4

Define Bacteraemia

Answer 4

• Presence of micro-organisms in bloodstream
• May be transiet e.g. dental procedures
• May be terminated by host immune system

Question 5

Define septicaemia

Answer 5

A syndrome consisting of:

• Sepsis
• Bacteraemia

Question 6

Sepsis damage brought about by cytokine cascade in seps

Answer 6

Question 7

Non-infectious causes of SIRS

Answer 7

Trauma

Burns

Pancreatitis

Haemorrhage; particularly intra-cranial

Question 8

COMMUNITy ONSET SEPSIS: UTI/pyelonephritis

Answer 8

E. coli

Question 9

COMMUNIT ONSET SEPSIS: Pneumonia

Answer 9

S. pneumoniae

Question 10

COMMUNITY ONSET SEPSIS: Skin/soft tissue/joint/bone

Answer 10

S.aureus

S. pyogenes

Question 11

COMMUNITY ONSET SEPSIS: Meningitis

Answer 11

N. meningitidis

Question 12

COMMUNITY ONSET SEPSIS: Intra-abdominal infection

Answer 12

E.coli

Question 13

COMMUNITY ONSET SEPSIS: Infective endocarditis

Answer 13

Streptococci

S. aures

Question 14

Risk factors for infective endocarditis

Answer 14

Valvular disease

Prostethic valve

Intravenous drug use

Central lines

Implantable cardiac devices

Question 15

Common organisms infective endocarditits

Answer 15

Streptococci (inc enterococci)

S. aureus

HACEK

PVE, also coagulase negatice staph

Question 16

Clinical considerations for S. pyogenes

Answer 16

• Common cause of tonsillitis and scarlet ever
• Penicillin sensitive
• Antistreptolysin O antibodies rise after tonsilitis

Question 17

Rheumatic fever and S.pyogenes relation

Answer 17

• Rheumatic fever may be caused by cross-reactivity following S.pyogenes infection
• Damage to connective tissue
• Fever, polyarthritis, carditis
• Untreated repeated attacks can cause valve damage

Question 18

Presentation in infective endocardits

Answer 18

Question 19

Diagnosing infective enocarditis

Answer 19

Question 20

Signs of Infective endocarditis

Answer 20

Question 21

Management of infective ednocarditis

Answer 21

Question 22

How many sets of microbiology results before ABs in sepsis

Answer 22

Minimum 2 in ideal circumstences

Question 23

NUH Sepsis Red Flags

Answer 23

Question 24

The sepsis sic resuscitation bundle

Answer 24