Sepsis Jeopardy

Definitions

100

Sepsis

Infection + dysregulated host response causing organ dysfunction (2 criteria)

200

Septic Shock

Sepsis + Persistent hypotension requiring adrenaline

300

SIRS Criteria

1. Tachycardia
2. Tachypnea
3. Fever or hypothermia
4. Leukocytosis, leukopenia, or bandemia

400

Bandemia

Increased immature white blood cells resulting from systemic infection

500

Equation for Mean Arterial Pressure (MAP)

MAP = Diastolic BP + 1/3 (Systolic BP - Diastolic BP)

Signs & Symptoms

100

List 3 symptoms

Nausea, vomiting, abdominal cramps, diarrhea, syncope, palpitations, etc

200

List 3 signs

Altered mental status, tachycardia, tachypnea, abdominal distension, flank pain, evidence of cellulitis, decreased breath sounds

300

Which is MOST concerning?

A. Fever
B. Elevated white blood cell count
C. Hypotension
D. Tachycardia

C

400

List 3 potential sources of sepsis

Abdominal, skin/soft tissue, respiratory, endocarditis, blood stream, urinary, meningitis, etc

500

What type of acid/base disturbance does sepsis cause?

Metabolic acidosis

Cases

100

Who has sepsis?
A. 45yM alcoholic, severe epigastric abdominal pain.
HR 100, BP 130/82, RR 18
B. 68yF dysuria, flank pain, altered mental status.
HR 108, BP 118/78, RR 22
C. 20yM motorcycle accident, large open femur fx.
HR 110, BP 124/82, RR 22

B

200

Who are you most concerned about?
A. 40yM, pancreatitis, BP 132/90, HR 87, WBC 18
B. 55yF, pneumonia, BP 115/75, HR 80, WBC 15
C. 70yF, UTI, BP 80/50, HR 112, WBC 16

C

300

Who has sepsis?
A. 68yF productive cough, altered mental status.
HR 108, BP 100/60, RR 22
B. 45yM alcoholic, vomiting blood.
HR 100, BP 130/82, RR 22
C. 20yF sudden onset, LLQ abdominal pain, pregnant.
HR 115, BP 120/80, RR 18

A

400

60yM, diabetes & hypertension, presents with 3 days history of fever, chills, and difficulty breathing. Leg wound is inflamed and draining pus.
Temp 38.5, HR 115, RR 28, BP 110/75
What is diagnosis?

Sepsis secondary to leg wound

500

78yF, diabetes, presents with 2 day history of fever, cough, and difficulty breathing. Crackles on exam.
Temp 38.7, HR 115, RR 28, BP 100/68
What is diagnosis?

Sepsis secondary to pneumonia

Management

100

How many SIRS Criteria are needed to diagnose Sepsis?

At least 2

200

Antibiotics should be administered to a patient with septic shock within ______ minutes

60

300

How will you treat a patient with sepsis within the first hour?

Antibiotics, IV fluid bolus, lactate, blood cultures

400

You diagnosed a patient with sepsis. Now they are hypotensive (BP 80/50), what should you administer? What dose?

IV Fluid: Normal Saline or Lactated Ringers

30mL/kg bolus

500

If blood pressure is still low after initial fluid bolus, what should be administered?

Adrenaline

Random

100

30yM presents with lower extremity wound with purulent drainage over the past week.
HR 100, RR 18, 98% RA, BP 115/75, 36.5, WBC 8
A. Infection (Skin/Soft Tissue)
B. Sepsis
C. Septic Shock

A

200

68yF presents with productive cough, difficulty breathing, and intermittent chest pain.
HR 108, RR 26, 99% RA, BP 120/75, 36.5
A. Infection (Pneumonia)
B. Sepsis
C. Septic Shock

B

300

What are 3 components of pathophysiology?

Vasodilatation, amplification, capillary leakage

400

Target urine output for an adult

0.5 cc/kg/hr

500

Why does lactate rise?

Anaerobic glycolysis due to tissue hypoxia