Podcast
Questions and Answers
Which of the following is a manifestation of sepsis?
Which of the following is a manifestation of sepsis?
- Stable mental status
- Decreased lactate levels
- Hypertension
- Oliguria (correct)
What is the definition of septic shock?
What is the definition of septic shock?
- Sepsis requiring pressors to maintain adequate organ perfusion (correct)
- Infection with altered mental status
- Sepsis with a mean arterial pressure (MAP) <65 mmHg
- Presence of a lactate <2
What is the most common cause of hospital admission?
What is the most common cause of hospital admission?
- Sepsis (correct)
- Diabetes
- Heart failure
- Pneumonia
Which patients are most at risk for hospital-acquired sepsis?
Which patients are most at risk for hospital-acquired sepsis?
What induces pro-inflammatory cytokines in the sepsis pathogenesis?
What induces pro-inflammatory cytokines in the sepsis pathogenesis?
What happens to the bone marrow in response to sepsis?
What happens to the bone marrow in response to sepsis?
What effect does sepsis have on blood vessels?
What effect does sepsis have on blood vessels?
What is a crucial test for sepsis diagnosis and monitoring?
What is a crucial test for sepsis diagnosis and monitoring?
Which patient factor puts individuals at higher risk for sepsis?
Which patient factor puts individuals at higher risk for sepsis?
What does UA with reflex C&S aim to detect in sepsis?
What does UA with reflex C&S aim to detect in sepsis?
Which test is used to identify signs of infection or trauma in sepsis?
Which test is used to identify signs of infection or trauma in sepsis?
What may be needed if the sepsis diagnosis is not apparent?
What may be needed if the sepsis diagnosis is not apparent?
Which imaging technique is used to identify sources of infection in sepsis?
Which imaging technique is used to identify sources of infection in sepsis?
What are some manifestations of sepsis?
What are some manifestations of sepsis?
What are the criteria for Systemic Inflammatory Response Syndrome (SIRS)?
What are the criteria for Systemic Inflammatory Response Syndrome (SIRS)?
What is used to assess organ failure risk in patients outside the ICU?
What is used to assess organ failure risk in patients outside the ICU?
Which stage of shock involves overwhelmed compensatory mechanisms and evident signs of organ dysfunction?
Which stage of shock involves overwhelmed compensatory mechanisms and evident signs of organ dysfunction?
What are the distinct characteristics and symptoms of pre-shock?
What are the distinct characteristics and symptoms of pre-shock?
What may patients in end-stage shock exhibit due to overwhelming infection?
What may patients in end-stage shock exhibit due to overwhelming infection?
What additional testing may be included for sepsis diagnosis?
What additional testing may be included for sepsis diagnosis?
What is the outcome of end-stage shock?
What is the outcome of end-stage shock?
What is the most crucial predictor of mortality in sepsis?
What is the most crucial predictor of mortality in sepsis?
Which IV fluid is recommended for initial resuscitation in sepsis/septic shock?
Which IV fluid is recommended for initial resuscitation in sepsis/septic shock?
What is the recommended antimicrobial therapy for sepsis?
What is the recommended antimicrobial therapy for sepsis?
Which pressor is used in distributive shock?
Which pressor is used in distributive shock?
What is essential for adequate gas exchange assessment in sepsis?
What is essential for adequate gas exchange assessment in sepsis?
What is a common consequence of inappropriate antibiotic selection in sepsis?
What is a common consequence of inappropriate antibiotic selection in sepsis?
Which lab abnormality is often seen in sepsis and can lead to mental impairment?
Which lab abnormality is often seen in sepsis and can lead to mental impairment?
What is crucial for the diagnosis of sepsis?
What is crucial for the diagnosis of sepsis?
What should antimicrobial therapy consider in sepsis management?
What should antimicrobial therapy consider in sepsis management?
Study Notes
Sepsis Management and Empiric Antibiotic Therapy
- Lab abnormalities in sepsis often include hypoglycemia leading to mental impairment
- Diagnosis involves assessing recent travel, infectious contacts, and allergies/medication reactions
- Physical examination is crucial to localize the site of infection in the lungs, heart, abdomen, neuro, and skin
- Extensive studies including CBC, chemistries, blood, urine and sputum culture, wound cultures, and CSF exam are necessary for diagnosis
- Time to initiation of appropriate antimicrobial therapy is the strongest predictor of mortality in sepsis
- Inappropriate antibiotic selection is common and markedly increases mortality
- Antimicrobial therapy must consider the source of sepsis, treating the most likely bugs, such as Gram positives, Gram negatives, and anaerobic infections
- Empiric antibiotic therapy includes vancomycin with cephalosporin or beta-lactam/beta-lactamase inhibitor, or combinations if Pseudomonas is a consideration
- IV fluid resuscitation in sepsis/septic shock starts with 0.9% NS or LR at a dose of 30 mL/kg IV within the first three hours
- Pressors like Levophed and dobutamine are used in distributive and cardiogenic shock, respectively
- Hematologic treatment includes Packed RBCs, Fresh frozen plasma, and Platelets
- Adequate gas exchange assessment involves supplemental oxygen, ABG test, intubation, and mechanical ventilation if necessary
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Description
Test your knowledge of sepsis management and empiric antibiotic therapy with this quiz. Learn about lab abnormalities, diagnosis, physical examination, antimicrobial therapy, IV fluid resuscitation, pressors, and hematologic treatment for sepsis and septic shock.
