Sepsis Management and Antibiotic Therapy Quiz

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Questions and Answers

What is the recommended initial antibiotic therapy for a newborn diagnosed with sepsis within the first 6-8 weeks of life?

  • Ampicillin and gentamicin, ampicillin and cefotaxime, or ampicillin and ceftriaxone (correct)
  • Vancomycin and a third-generation cephalosporin
  • A third-generation cephalosporin plus clindamycin
  • Broad-spectrum antibiotics with an emphasis on Gram-negative bacteria

What antibiotic therapy is typically recommended for older infants and children with sepsis of unknown origin who do not have an indwelling catheter?

  • A third-generation cephalosporin plus vancomycin and clindamycin if *S. aureus* is suspected
  • Ampicillin and gentamicin
  • A third-generation cephalosporin plus vancomycin (correct)
  • Vancomycin alone

Which of the following is an adjunctive therapy that may be considered in the management of sepsis?

  • Routine use of corticosteroids
  • Intravenous immunoglobulin (IVIg) (correct)
  • Intramuscular injections of antibiotics
  • Early enteral nutrition

Which of these best describes the nutritional recommendations for a patient with sepsis in the initial phase?

<p>Patients should not be fed until gut hypoxia and hypoperfusion have been excluded. (C)</p> Signup and view all the answers

What antibiotic approach should be considered for patients with sepsis who have an indwelling catheter or are at high risk for MRSA?

<p>A third-generation cephalosporin plus vancomycin with the possible addition of clindamycin (C)</p> Signup and view all the answers

What is the primary consequence of coagulation and endothelial damage in small blood vessels during sepsis?

<p>Impeded blood flow, leaky vessels, and clot formation (C)</p> Signup and view all the answers

What is the direct result of fluid and microorganisms escaping into lung tissues during sepsis?

<p>Pulmonary oedema and shortness of breath (B)</p> Signup and view all the answers

Which of the following is seen as a consequence of the exhaustion of coagulation proteins during sepsis?

<p>Excessive bleeding (B)</p> Signup and view all the answers

What is a key effect of cytokines on blood vessels during sepsis?

<p>Vasodilation and decreased blood pressure (D)</p> Signup and view all the answers

The inadequate tissue perfusion during sepsis leads to:

<p>Cellular hypoxia and lactic acidosis (A)</p> Signup and view all the answers

Which of the following is a recognized diagnostic sign of sepsis?

<p>Leukocytosis (WBC count &gt;12,000) (D)</p> Signup and view all the answers

Why is identifying a specific organism not always essential for diagnosing sepsis?

<p>Because a culprit organism is often not found (D)</p> Signup and view all the answers

How would you characterize the role of nitric oxide in blood pressure regulation in sepsis?

<p>It is produced excessively, contributing to widespread hypotension. (D)</p> Signup and view all the answers

According to the information provided, what is the primary cause of sepsis?

<p>A dysregulated host response to an infection. (A)</p> Signup and view all the answers

Which of the following is a key component used to identify patients at higher risk of poor outcomes outside the ICU?

<p>The quick Sequential Organ Failure Assessment (qSOFA) score. (B)</p> Signup and view all the answers

What is the new clinical criteria for septic shock?

<p>Sepsis with fluid-unresponsive hypotension, serum lactate level greater than 2 mmol/L, and use of vasopressors to maintain mean arterial pressure &gt; 65mmHg. (C)</p> Signup and view all the answers

What is an important limitation of the qSOFA as mentioned in the provided content?

<p>It is not intended to replace clinical judgement. (B)</p> Signup and view all the answers

An ICU admission can increase the risk of sepsis due to:

<p>The high prevalence of nosocomial infections. (C)</p> Signup and view all the answers

Which of the following factors predisposes a patient to the systemic consequences of infection?

<p>Bacteremia (D)</p> Signup and view all the answers

A patient presents to the emergency department with a suspected infection. Their blood pressure is 90/60 mmHg, respiratory rate is 26 breaths per minute, and they are confused. According to the qSOFA criteria, how many points do they score?

<p>3 points (B)</p> Signup and view all the answers

A patient in the ICU has a suspected infection. According to the new sepsis criteria for septic shock, which of these findings would indicate they have septic shock?

<p>Fluid unresponsive hypotension, serum lactate 3mmol/L and vasopressors to maintain MAP &gt;65 mmhg (D)</p> Signup and view all the answers

When should patients with sepsis ideally begin feeding?

<p>After ruling out gut hypoxia and hypoperfusion (C)</p> Signup and view all the answers

In addition to antibiotics, which of these is a possible adjunctive therapy that may be considered for sepsis?

<p>Intravenous immunoglobulin (IVIg) (D)</p> Signup and view all the answers

What is the recommended approach for antibiotic therapy in patients with sepsis who are also at high risk for MRSA?

<p>A third-generation cephalosporin plus vancomycin (C)</p> Signup and view all the answers

For patients with sepsis and fever accompanied by neutropenia, antibiotic therapy focuses on:

<p>Gram-negative bacteria coverage (A)</p> Signup and view all the answers

In the case of older infants and children with sepsis of unknown cause, the recommended antibiotic therapy is:

<p>A third-generation cephalosporin plus vancomycin (A)</p> Signup and view all the answers

What best characterizes the current definition of sepsis?

<p>A life-threatening clinical condition due to an unregulated immune response to infection. (C)</p> Signup and view all the answers

Which of the following is a key component of the qSOFA score?

<p>Low blood pressure, high respiratory rate, and altered mentation. (B)</p> Signup and view all the answers

A patient with a suspected infection presents with a systolic blood pressure of 95 mmHg, a respiratory rate of 24 breaths per minute, and is slightly confused. Based on qSOFA criteria, how would this patient be categorized?

<p>Two qSOFA points (C)</p> Signup and view all the answers

Which of the following findings would be most indicative of septic shock according to the new clinical criteria?

<p>Hypotension, serum lactate level greater than 2 mmol/L, and the need for vasopressors to maintain adequate mean arterial pressure. (B)</p> Signup and view all the answers

According to the content, what differentiates septic shock from sepsis?

<p>Septic shock is sepsis combined with circulatory and cellular/metabolic dysfunction, which can increase mortality risk. (D)</p> Signup and view all the answers

What is stated about the limitations of qSOFA?

<p>It is useful in raising suspicion of sepsis but does not replace clinical judgement. (D)</p> Signup and view all the answers

Which of these scenarios increases the intrinsic risk of sepsis?

<p>A patient requiring admission to the intensive care unit (ICU). (D)</p> Signup and view all the answers

How is the concept of bacteremia related to sepsis risk?

<p>Patients with bacteremia often develop systemic consequences of infection. (A)</p> Signup and view all the answers

Which of the following best describes the progression from cellular injury to organ dysfunction in sepsis?

<p>Cellular injury leads to the release of inflammatory mediators, which can result in organ dysfunction. (B)</p> Signup and view all the answers

What is the effect of nitric oxide overproduction in sepsis?

<p>It contributes to a decrease in blood pressure due to excessive vasodilation. (D)</p> Signup and view all the answers

Which of the following indicates a hyperlactatemia diagnostic sign of sepsis?

<p>Lactate levels greater than 4 mg/dL (70 micromol/L). (D)</p> Signup and view all the answers

In the context of sepsis, what does the term 'inadequate tissue perfusion' directly lead to?

<p>Reduced cellular oxygen levels (hypoxia) and build-up of lactic acid. (D)</p> Signup and view all the answers

Which of the following physiological effects is NOT typically associated with the early stages of sepsis?

<p>Normal levels of carbon dioxide in the blood. (D)</p> Signup and view all the answers

Why is the identification of a specific microorganism not essential for a diagnosis of sepsis?

<p>Identifying the organism is not possible in all patients with sepsis, its absence does not invalidate the diagnosis. (A)</p> Signup and view all the answers

What is the consequence of a significant loss of coagulation factors that may occur in sepsis?

<p>Uncontrolled bleeding due to the exhaustion of coagulation proteins. (A)</p> Signup and view all the answers

What is a common clinical manifestation of pulmonary oedema which can occur secondary to sepsis?

<p>Difficulty in breathing or shortness of breath. (B)</p> Signup and view all the answers

What is the primary factor differentiating septic shock from sepsis?

<p>A significant drop in blood pressure despite fluid resuscitation (B)</p> Signup and view all the answers

Which of these best characterizes the progression from cellular injury to organ dysfunction in sepsis?

<p>Inflammation and coagulation cascade activation leading to tissue damage (D)</p> Signup and view all the answers

A patient with a suspected infection is admitted to the ICU. Which of the following findings would most strongly indicate septic shock based on the new clinical criteria?

<p>A systolic blood pressure of 90 mmHg despite fluid resuscitation (B)</p> Signup and view all the answers

Which of the following is a diagnostic sign of sepsis?

<p>Elevated serum creatinine (A)</p> Signup and view all the answers

Which of the following therapies is commonly used for older infants and children with sepsis of unknown origin?

<p>A third-generation cephalosporin plus vancomycin (C)</p> Signup and view all the answers

What is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection?

<p>Sepsis (C)</p> Signup and view all the answers

Which of the following symptoms is NOT typically associated with sepsis?

<p>Persistent diarrhea (B)</p> Signup and view all the answers

Which of the following management strategies is essential for a patient diagnosed with sepsis?

<p>Fluid resuscitation (D)</p> Signup and view all the answers

What is one of the criteria for identifying patients at greater risk for poor outcomes based on the qSOFA score?

<p>Low blood pressure (SBP≤100 mmHg) (D)</p> Signup and view all the answers

Which statement about septic shock is accurate?

<p>It is a subset of sepsis associated with higher mortality risk. (A)</p> Signup and view all the answers

What does the qSOFA score NOT replace in diagnosing sepsis?

<p>Systemic inflammatory response syndrome (SIRS) (D)</p> Signup and view all the answers

Which of the following is considered a sign of septic shock under new clinical criteria?

<p>Vasopressors required to maintain mean arterial pressure &gt; 65 mmHg (A)</p> Signup and view all the answers

What is one risk factor that increases the likelihood of developing sepsis?

<p>Admittance to the intensive care unit (ICU) (D)</p> Signup and view all the answers

What is the primary definition of sepsis?

<p>A systemic inflammatory response to infection that can lead to organ dysfunction. (D)</p> Signup and view all the answers

Which of the following is NOT a typical sign of sepsis?

<p>Increased platelet count (B)</p> Signup and view all the answers

What complication can arise due to inadequate tissue perfusion in sepsis?

<p>Cellular hypoxia and lactic acidosis (C)</p> Signup and view all the answers

Which of these statements regarding the management of sepsis is accurate?

<p>Fluid resuscitation is often recommended to restore hemodynamic stability. (C)</p> Signup and view all the answers

What does hyperlactatemia indicate in a patient with sepsis?

<p>Inadequate tissue oxygenation and anaerobic metabolism. (A)</p> Signup and view all the answers

What role do cytokines play during sepsis?

<p>They induce blood vessel dilation and can lower blood pressure. (B)</p> Signup and view all the answers

What is a common physiological effect observed in the early stages of sepsis?

<p>Fever and chills due to infection (D)</p> Signup and view all the answers

Why might a specific microorganism not be identified in many sepsis cases?

<p>The patient may have already received antibiotics before the culture. (B)</p> Signup and view all the answers

Flashcards

Sepsis

A life-threatening condition where the body's response to infection becomes uncontrolled, leading to organ dysfunction.

Septic Shock

A severe form of sepsis with dangerously low blood pressure and impaired cellular function, increasing mortality risk.

qSOFA score

A bedside assessment tool using three criteria (low blood pressure, high respiratory rate, altered mental status) to identify patients at risk for poor outcomes outside the ICU.

SIRS (Systemic Inflammatory Response Syndrome)

A systemic inflammatory response syndrome (SIRS) with a confirmed infection.

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Septic Shock (New criteria)

A severe form of sepsis with hypotension, elevated lactate levels, and need for medication to maintain blood pressure.

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Bacteremia

A condition where bacteria are present in the bloodstream.

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Nosocomial Infections

Hospital-acquired infections occurring in patients while hospitalized, increasing sepsis risk.

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ICU Infections

A type of infection occurring in patients within the intensive care unit (ICU).

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Sepsis of unclear etiology

A type of sepsis where the cause of infection is unknown, typically seen in older infants and children.

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Vancomycin

A powerful antibiotic used to fight infections caused by Staphylococcus aureus, especially the resistant MRSA strain.

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Third-generation cephalosporins

An antibiotic group known for their broad spectrum, effectively targeting a wide range of bacteria, especially Gram-negative bacteria.

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Clindamycin

A common antibiotic used to treat infections caused by Staphylococcus aureus, including methicillin-resistant strains (MRSA).

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Intravenous immunoglobulin (IVIg)

A type of immune system booster administered intravenously, sometimes used as an adjunctive therapy in sepsis.

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Coagulation Response in Sepsis

Blood clots forming in small blood vessels due to infection, leading to leakage and swelling.

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Pulmonary Edema in Sepsis

Fluid buildup in the lungs due to leaky blood vessels and an infection, causing shortness of breath.

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Hypotension in Sepsis

A decrease in blood pressure caused by widened blood vessels due to infection.

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Inadequate Tissue Perfusion in Sepsis

Insufficient blood flow to tissues due to sepsis, leading to cell damage and organ dysfunction.

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Cytopathic Injury in Sepsis

Direct cell injury caused by infection or its byproducts, leading to organ dysfunction.

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Inflammatory Response in Sepsis

The body's response to infection, involving releasing pro-inflammatory and anti-inflammatory chemicals, leading to organ dysfunction.

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Leukocytosis in Sepsis

A high white blood cell count in the blood, indicating infection.

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Thrombocytopenia in Sepsis

A low platelet count in the blood, indicating potential bleeding problems in sepsis.

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What is sepsis?

A life-threatening medical condition where the body's response to infection is dysregulated, leading to organ dysfunction.

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What is septic shock?

A subset of sepsis with dangerously low blood pressure and impaired cellular function, increasing mortality risk.

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What is the qSOFA score?

A bedside assessment tool used to identify patients at risk for poor outcomes outside the ICU. It evaluates blood pressure, respiratory rate, and mental status.

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What is bacteremia?

A condition where bacteria are present in the bloodstream.

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What are nosocomial infections?

Hospital-acquired infections occurring in patients while hospitalized, increasing sepsis risk.

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What are the new criteria for septic shock?

A serious type of sepsis with hypotension, elevated lactate levels, and the need for medication to maintain blood pressure.

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What is sepsis of unclear etiology?

Sepsis where the cause of infection is unknown, commonly seen in infants and children.

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What is Vancomycin?

A powerful antibiotic used to fight infections caused by Staphylococcus aureus, especially the resistant MRSA strain.

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Sepsis treatment in infants and children

Ampicillin and a third-generation cephalosporin (like ceftriaxone or cefotaxime) are used to treat sepsis in infants and children. These antibiotics target a broad range of bacteria, including those that commonly cause infection in this age group.

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Sepsis treatment: Beyond infants and children

For older children and adults with sepsis, antibiotics like vancomycin are often added to a third-generation cephalosporin. This combination provides wider coverage, especially for more serious bacteria like MRSA.

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Sepsis treatment for high-risk patients

Patients with implanted devices like catheters or those at high risk of MRSA infection often receive vancomycin in addition to the standard antibiotic regimen. This additional protection prevents complications from these difficult bacteria.

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Sepsis of unclear etiology: Treatment

If the cause of sepsis is unclear in infants and children, a third-generation cephalosporin combined with vancomycin is commonly prescribed. Clindamycin may be added if Staphylococcus aureus is suspected.

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Sepsis treatment for neutropenia

Patients with fever and neutropenia, a low white blood cell count, often need broad-spectrum antibiotics to target a variety of Gram-negative bacteria. This approach addresses potential infections in a weakened immune system.

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Coagulation in Sepsis

When tiny blood vessels are damaged due to infection, blood clots form, blocking blood flow and causing the vessels to leak, leading to swelling in surrounding tissues.

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Blood Cell Count in Sepsis

In sepsis, a high white blood cell count indicates the body is fighting an infection, while a low platelet count warns of potential bleeding complications.

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Diagnosing Sepsis

Multiple types of evidence are needed for a sepsis diagnosis including clinical symptoms, lab test results, imaging scans, physiological measurements, and the identification of microbes in the body.

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