Sepsis And Septic Shock

Question 1

Definition of sepsis

Answer 1

Life-threatening organ dysfunction caused by a dysregulated immunity response to infection.

Question 2

Definition of septic shock

Answer 2

Subset فرع of sepsis in which there are profound circulatory , cellular and metabolic abnormalities.
* Associated with a high risk of mortality.

Question 3

Complications of septic shock

Answer 3

*DIC
*AKI
*ARDS
*Heart failure
*Hypoglycemia

Question 4

Management of septic shock

Answer 4

1-Resuscitation:
* Intubation (if needed)
* CVP (Central Venous Pressure) monitoring
* Assessment (frequent vital signs, etc.)
* IV Fluids:
2- Administer crystalloid fluids.
3- Vasopressors for Hypotension:
* Initiate if blood pressure remains low despite adequate fluid resuscitation.
* Examples: Norepinephrine is often the first-line choice.

Question 5

Management of septic shock

Answer 5

4- Empirical Antibiotics: (Start within 1 hour of sepsis recognition, especially in high-risk groups)
طب هندي ايه بقي ؟
قول انت
*Monotherapy
*2nd line dual therapy (1st line +aminoglycosides

Question 6

Management of septic shock

Answer 6

5- vancomycin is added in cases of:
*Skin,soft tissue infection
*Urinary catheter infection
*MRSA
*G-ve blood cultures.
*Persistent hypotension

Question 7

Management of septic shock

Answer 7

6-Antifungal in immunocompromised patients
7-statins : act as
*Anti inflammatory
*Antioxidant
*Anti apoptotic effect.
*Immunoregulatory.
8-surgery in cases of wound debridement,abcess drainge

Question 8

Severe sepsis

Answer 8

Sepsis +signs of end organ damage
Lactate >4
Systolic blood pressure<90

Question 9

Qick Sofa score
بالمرة

Answer 9

qSOFA Criteria (1 point each):

1. Altered mentation (Glasgow Coma Scale < 15)
2. Respiratory rate ≥ 22/min
3. Systolic blood pressure ≤ 100 mmHg

Interpretation:

Score ≥ 2 suggests a higher risk of sepsis and need for further investigation or escalation of care.

Question 10

Clinical findings/lab.results/sepsis scoring (NEWS2-SOFA-APACHE II)/onset
of resuscitation /type of organism/response to empiric antibiotic AS predictors
of mortality
بجملة العبط بقي

Answer 10

1-Prediction of mortality
(Canatlup motlingالتحشيشة)
Cold extremities
Altered mental status
NEWS > 7
Thrombocytopenia
APACHE score > 20
Lactate > 4
Urine out put < 0.5ml/kg/hour
Prolonged capillary refill & Raised INR
Capillary refill > 3 second
Prolonged hypotension & Tachycardia
Motling of Skin
لو نسيت
APACHE II>20
Sofa score ≥2
News score ≥7
2-Sepsis Associated with Certain organism, (,Pseudomonas, Candida, Polymicrobial)
3-HAP infection predict poor prognosis
4-G-ve bacteria grown from blood stream are resistant to empiric regimen