55 Questions
Which organization still supports the previous definitions of systemic inflammatory response syndrome, sepsis, and severe sepsis?
Center for Medicare and Medicaid Services (CMS)
Which guidelines are the management of sepsis and septic shock consistent with?
Surviving Sepsis Campaign 2021 guidelines
Which of the following is NOT a potential indicator of the severity of sepsis?
Elevated procalcitonin
What is the recommended upper limit of normal for serum lactate to indicate the severity of sepsis?
2 mmol/L
What is the sensitivity of post-antimicrobial blood cultures in identifying pathogens in patients with sepsis?
53 percent
What is the mortality benefit associated with procalcitonin use in patients with sepsis?
15 percent
Which of the following is NOT a priority in the management of patients with sepsis and septic shock?
Administering antibiotics
What is the ideal target range for peripheral saturation in patients with sepsis who require oxygenation?
90-96 percent
When is intubation and mechanical ventilation typically required in patients with sepsis?
To support increased work of breathing
When should central venous access be established in patients with suspected sepsis?
As soon as possible
Which of the following is NOT mentioned as a potential marker of tissue perfusion after the restoration of perfusion?
Lactate clearance
Which of the following laboratory studies are often performed until values have reached normal or baseline?
Platelet count
Which of the following investigations should be considered in patients with sepsis within the first 12 hours?
Cultures and diagnostic samples
Which of the following is NOT mentioned as a potential serologic assay for suspected invasive Candida or Aspergillus infection?
Cultures
Which of the following is NOT mentioned as a potential source control measure in sepsis?
Angioplasty
What is the potential risk of complications associated with source control interventions in sepsis?
Fistula formation
What should be taken into consideration when deciding on the type and timing of source control in sepsis?
All of the above
What is the recommended timing for source control in sepsis according to guidelines?
Within 6 to 12 hours after diagnosis
What is the potential impact of inadequate source control in sepsis?
Increased risk of complications
Which of the following interventions is mentioned as a potential source control measure in sepsis?
All of the above
Which of the following is a target used to measure the response in the protocol-based approach for treating sepsis?
Mean arterial pressure (MAP) ≥65 mmHg
Which of the following statements is supported by the evidence regarding early goal-directed therapy (EGDT) for sepsis?
EGDT targets include central line placement and lactate clearance.
Which of the following statements is NOT true regarding the use of permissive hypotension in septic shock?
Permissive hypotension is associated with increased hospital mortality in patients aged 75 years or older.
Which of the following statements is supported by the evidence regarding the mortality benefit of resuscitation protocols for septic shock?
A meta-analysis of 13 trials reported a mortality benefit from early-goal directed therapy within the first six hours.
Which of the following is considered a dynamic measure of fluid responsiveness?
Radial artery pulse pressure
Which of the following is NOT a static CVC measurement used to determine adequate fluid management?
MAP
Which of the following is true regarding lactate clearance?
Lactate clearance is defined by the equation [(initial lactate – lactate >2 hours later)/initial lactate] x 100.
Which of the following meta-analyses reported a reduction in mortality when lactate clearance strategies were used compared with usual care or ScvO2 normalization?
One meta-analysis of five low quality trials
Which of the following is a key characteristic of sepsis?
It can result in organ dysfunction.
What is the recommended approach for managing sepsis in the hospital setting?
Using a performance improvement program.
What is the impact of sepsis worldwide?
It kills between one in three and one in six of those it affects.
What is the purpose of the recommendations in the guidelines?
To reflect best practice in sepsis management.
Which of the following is NOT a recommendation for the initial resuscitation of patients with sepsis-induced hypoperfusion or septic shock?
Guide resuscitation to decrease serum lactate in patients with elevated lactate levels.
Which of the following is a weak recommendation for the management of adults with sepsis or septic shock?
Use capillary refill time to guide resuscitation.
Which of the following is a strong recommendation for the management of adults with septic shock on vasopressors?
Maintain a mean arterial pressure (MAP) of 65 mm Hg.
Which of the following is a best practice statement for the management of adults with sepsis or septic shock?
Treat and resuscitate immediately.
Which of the following is a strong recommendation for adults with sepsis or septic shock at low risk of fungal infection?
Empiric use of antifungal therapy
Which of the following is a best practice statement for adults with sepsis or septic shock?
Daily assessment for de-escalation of antimicrobials
Which of the following is a strong recommendation for fluid resuscitation in adults with sepsis or septic shock?
Using balanced crystalloids
Which of the following is a strong recommendation for vasopressor use in adults with septic shock?
Norepinephrine as the first-line agent
Which of the following is NOT a component of sepsis performance improvement programs?
Patient outcomes
Which of the following is NOT a sepsis screening tool?
Quick Sequential Organ Failure Score (qSOFA) criteria
Which of the following is NOT associated with higher diagnostic accuracy for sepsis screening?
Modified Early Warning Score (MEWS)
Which of the following is NOT mentioned as a potential location for sepsis screening?
Outpatient clinics
Which vasopressor is suggested to be added for adults with septic shock on norepinephrine with inadequate mean arterial pressure levels?
Vasopressin
What is the recommendation for adults with septic shock and inadequate mean arterial pressure levels despite norepinephrine and vasopressin?
Add epinephrine
What is the recommendation for adults with septic shock and cardiac dysfunction with persistent hypoperfusion despite adequate volume status and arterial blood pressure?
Add dobutamine to norepinephrine or use epinephrine alone
Which of the following is a recommended therapy for adults with sepsis-induced moderate-severe ARDS?
Intermittent NMBA boluses
In which situation is the use of Veno-venous (VV) ECMO suggested for adults with sepsis-induced severe ARDS?
When conventional mechanical ventilation fails in experienced centers
What therapy is suggested for adults with septic shock and an ongoing requirement for vasopressor therapy?
IV corticosteroids
What is the dose of IV hydrocortisone suggested for septic shock patients if adequate fluid resuscitation and vasopressor therapy are unable to restore hemodynamic stability?
200 mg/day
Which of the following statements regarding the administration of antimicrobials for adults with possible septic shock or sepsis is correct?
Antimicrobials should be administered within 1 hour of recognition for both septic shock and sepsis without shock.
Which of the following statements regarding the assessment of the likelihood of infectious versus noninfectious causes of acute illness for adults with possible sepsis without shock is correct?
Rapid investigation should be conducted if concern for infection persists.
Which of the following statements regarding the administration of antimicrobials for adults with a low likelihood of infection and without shock is correct?
Antimicrobials should be deferred while closely monitoring the patient.
Which of the following statements regarding the use of procalcitonin plus clinical evaluation to decide when to start antimicrobials for adults with suspected sepsis or septic shock is correct?
Procalcitonin plus clinical evaluation should not be used to decide when to start antimicrobials.
"Quiz: Evaluating and Managing Suspected Sepsis and Septic Shock" - Test your knowledge on the evaluation and management of suspected sepsis and septic shock, including topics such as removing infected implantable devices, abscess drainage, nephrostomy, debridement, and more.
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