Pathogens
Physical Exam
Labs
Management
100
What pathogen do we suspect based on the picture below?
Herpes simplex virus
100
Is hypotension an early or late finding in pediatric sepsis?
Late finding
100
What does elevation of blood lactate >2.0 mmol/L (18 mg/dL) suggest?
Tissue hypoperfusion
100
What are the two most important therapies for patients presenting with septic shock?
Antibiotics and fluids
200
Fungal infections, especially which species, have been reported in 10 percent of pediatric patients with severe sepsis and septic shock?
Candida species
200
What is the distinguishing factor between SIRS and sepsis?
When the source of SIRS is an infection, it's called sepsis.
200
Can procalcitonin and C-reactive protein may be elevated in the absence of serious bacterial infection or sepsis?
Yes
200
Children with septic shock and no signs of fluid overload should receive how much fluid?
10 to 20 mL/kg
300
What is the most commonly isolated organism in hospital-acquired bacterial infections, such as catheter-associated bloodstream infections?
Coagulase-negative Staphylococcus
300
Other than abnormal temperature or leukocyte count, what are the other two criteria that define SIRS?
1) Tachycardia, defined as a mean heart rate more than two standard deviations above normal for age, or for children younger than one year of age, bradycardia defined as a mean heart rate <10th percentile for age
2) Mean respiratory rate more than two standard deviations above normal for age or mechanical ventilation for an acute pulmonary process
300
Patients with sepsis frequently have inadequate tissue perfusion with what kind of acidosis?
Lactic acidosis
300
What type of fluid is ideal for resuscitation?
Balanced crystalloid solution
400
The hallmark of what condition is a blanching erythematous rash with macules that become petechial over time?
Rocky Mountain spotted fever
400
What kind of shock is characterized by hyperdynamic (or high output) physiology with decreased systemic vascular resistance and elevated cardiac output?
Distributive ("warm") shock
400
Hypocalcemia (ionized calcium <1.1 mmol/L) may affect myocardial function and vascular tone and should be corrected if present. If serum calcium is abnormal, which other two electrolytes should be measured?
Serum phosphorus and magnesium
400
What is the major goal for the initial treatment of septic shock?
Rapid fluid resuscitation to restore tissue perfusion
500
For young infants three months of age or younger, what are the two gram-negative organisms that are most frequently isolated?
Escherichia coli and Group B streptococcus
500
What kind of shock reflects increased systemic vascular resistance and decreased cardiac output?
Cold shock
500
What lab is part of the criteria for pediatric SIRS?
Age-specific leukocytosis or leukopenia
500
For children with fluid-refractory, hypotensive septic shock, what therapy is suggested?
Epinephrine infusion or norepinephrine infusion