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Questions and Answers
A patient presents with a localized skin infection and develops a fever, elevated heart rate, and increased respiratory rate. Which condition is the MOST likely initial systemic response?
A patient presents with a localized skin infection and develops a fever, elevated heart rate, and increased respiratory rate. Which condition is the MOST likely initial systemic response?
- Systemic Inflammatory Response Syndrome (SIRS) (correct)
- Hematogenous dissemination
- Septic shock
- Endocarditis
Which of the following scenarios BEST describes a case of transient bacteraemia?
Which of the following scenarios BEST describes a case of transient bacteraemia?
- A patient with endocarditis experiencing persistent bacteria in the bloodstream.
- A patient with a urinary tract infection (UTI) and recurring episodes of bacteraemia.
- A patient undergoing a colonoscopy who then has bacteria detected in their blood for a short period. (correct)
- A patient with a catheter-related infection exhibiting continuous bacteraemia.
A patient in septic shock requires vasopressors to maintain a Mean Arterial Pressure (MAP) of at least 65 mmHg. What additional laboratory finding is MOST indicative of septic shock severity according to the Sepsis-3 criteria?
A patient in septic shock requires vasopressors to maintain a Mean Arterial Pressure (MAP) of at least 65 mmHg. What additional laboratory finding is MOST indicative of septic shock severity according to the Sepsis-3 criteria?
- Normal WBC count.
- Decreased respiratory rate.
- Serum lactate level > 2 mmol/L. (correct)
- A normal serum lactate level.
Which condition involves microorganisms multiplying actively within the circulating blood?
Which condition involves microorganisms multiplying actively within the circulating blood?
A patient with pneumonia develops sepsis. Which of the following criteria would necessitate assessment using the SOFA scoring system rather than the qSOFA?
A patient with pneumonia develops sepsis. Which of the following criteria would necessitate assessment using the SOFA scoring system rather than the qSOFA?
Which of the following is the MOST accurate definition of sepsis according to the Sepsis-3 definition?
Which of the following is the MOST accurate definition of sepsis according to the Sepsis-3 definition?
A patient has a central venous catheter in place and develops a bloodstream infection. What type of bacteraemia is MOST likely to be associated with this scenario?
A patient has a central venous catheter in place and develops a bloodstream infection. What type of bacteraemia is MOST likely to be associated with this scenario?
A patient is suspected of having sepsis in the emergency department. Which qSOFA criteria indicates a need for closer monitoring and possible intervention?
A patient is suspected of having sepsis in the emergency department. Which qSOFA criteria indicates a need for closer monitoring and possible intervention?
Hematogenous dissemination of bacteria from a focus of infection can lead to which of the following complications?
Hematogenous dissemination of bacteria from a focus of infection can lead to which of the following complications?
A patient presents with a high fever, rapid heart rate, and elevated white blood cell count. Which additional symptom is MOST indicative of Systemic Inflammatory Response Syndrome (SIRS)?
A patient presents with a high fever, rapid heart rate, and elevated white blood cell count. Which additional symptom is MOST indicative of Systemic Inflammatory Response Syndrome (SIRS)?
Flashcards
Bacteraemia
Bacteraemia
Bacteria in the bloodstream; blood is normally sterile.
Fungaemia
Fungaemia
Fungi in the bloodstream; blood is normally sterile.
Viraemia
Viraemia
Viruses in the bloodstream; blood is normally sterile.
Sepsis
Sepsis
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Septic Shock
Septic Shock
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SIRS
SIRS
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qSOFA Criteria
qSOFA Criteria
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Septic Shock Criteria
Septic Shock Criteria
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Hematogenous dissemination
Hematogenous dissemination
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SOFA
SOFA
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Study Notes
- Bacteraemia refers to bacteria in the blood.
- Fungaemia refers to fungi in the blood.
- Viraemia refers to viruses in the blood.
- Normally, blood is sterile.
- Bacteria can enter the bloodstream from localized infections like UTIs, pneumonia, and meningitis.
- Surgery can introduce bacteria into the bloodstream via mucous membranes.
- Medical devices such as catheters can be a source of bacteria in the bloodstream.
Types of Bacteraemia
- Continuous bacteraemia occurs in conditions like endocarditis, sepsis, and intravascular catheter-related infections.
- Intermittent bacteraemia stems from localized infections in areas such as the lungs, urinary tract, or soft tissues.
- Transient bacteraemia is common and typically not clinically significant; it can occur after procedures like dental work, bronchoscopy, or cystoscopy.
SIRS (Systemic Inflammatory Response Syndrome)
- SIRS symptoms include abnormal temperature, high heart rate, rapid breathing, and abnormal white blood cell count.
- Temperature is > 38°C.
- Heart rate is > 90 BPM.
- Respiratory rate is > 20 bpm.
- White blood cell count is < 4,000 cells/mm³ or > 12,000 cells/mm³ or > 10% band forms.
Sepsis & Septic Shock
- Consequences of bacteraemia can include sepsis, which is body-wide inflammation.
- Septic shock involves a severe drop in blood pressure and has a high mortality rate.
- Hematogenous dissemination refers to the spread of infections to other organs.
Sepsis Definitions
- Sepsis-3 definition (2016): Life-threatening organ dysfunction caused by a dysregulated host response to infection.
- Clinical criteria for sepsis: infection + ≥2 SOFA/qSOFA points.
- SOFA (Sequential Organ Failure Assessment) points refer to a scoring system used to assess the severity of a patient's organ dysfunction.
SOFA & qSOFA Scores
- SOFA is an ICU-based assessment.
- qSOFA is a quick, bedside assessment for patients with suspected infections at greater risk for poor outcomes outside the ICU.
- qSOFA criteria includes low blood pressure (SBP ≤ 100 mmHg), high respiratory rate (≥22 bpm), and altered mental status.
Septic Shock
- Septic shock is a severe subset of sepsis involving circulatory, cellular, and metabolic anomalies associated with a greater risk of mortality than sepsis alone.
- Septic shock requires vasopressors to maintain MAP ≥ 65 mmHg.
- Septic shock has high serum lactate levels > 2mmol/l.
- There is no absolute biomarker (yet) for sepsis or septic shock.
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