Q.10
If you had the capability, which of the following Labs/Diagnostics would be LEAST helpful during diagnosis and management of sepsis?
*
WBC, 12,000 cells/mm3 or higher, 4,000 cells/mm3 or less, or more than 10% bands on differential
Glomerular filtration rate
Creatinine
Electrolyte Levels
Urine output
Ultrasound
Blood Glucose Level
Lactate
Serum Lipase and Amylase levels
Q.1
What sign described in the scenario, tells you as the provider that your patient could be in trouble?
Blood Pressure
SpO2
Heart Rate
Mental Status
Q.3
If this patient does not respond to crystalloids, you need to switch to synthetic colloids such as hespan or hetastarch to limit the "third spacing" of fluid, while maintaining blood pressure.
Absolutely, your priority is blood pressure
Are you kidding, synthetic colloids are contraindicated. Maybe albumin if I can get my hands on some
Fresh whole blood transfusion
Q.6
Regarding Glucose levels, Which of the following medications are you more likely to be administer to a septic patient?
*
Glucose, They may be hypoglycemic from their body working hard fighting the infection.
Insulin, they may be hyperglycemic and need more normalized glucose levels.
Large doses of Insulin to induce hypoglycemia, which gives the bacteria less sugar to eat.
Q.5
Which Ventilation strategy should be used on septic patients?
*
High Tidal Volume, Low PEEP.
Lung Protective Strategy
Do not ventilate any septic patients, let them breathe on their own.
Short term hyperventilation to 35-45mmhg ETCO2 in order to reduce respiratory waste and therefore metabolic waste.
Obstructive Strategy
Q.9
Which of the following statements regarding sepsis management in PFC is true:
*
Giving Diuretics such as Mannitol and Lasix improves GFR and patient outcome.
Even if the patient is tolerating oral intake, Oral antibiotics should be avoided.
Acetaminophen may blunt physiological responses, so consider avoiding for the first 12-24 hours.
If you have limited crystalloids, refrain from using it until patient has signs of septic shock. Treatment is more important than prevention in Sepsis.
If all you carry is Epinephrine, it is not worth using it as a pressor due to negative effects. Use norepinphrine or no pressors at all.
Q.7
Sepsis treatments include all of the following, Except:
*
Identification and removal of course of infection (Incision & Drainage, removing infected lines)
Blood products for hypotension
Early Antibiotics
Pressor Therapy
Intravenous Fluids
Q.8
Mean Arterial Pressure and Urine Output goals for the septic patient should be:
*
MAP >65, UOP at least .5ml/kg/hr
MAP >50, UOP at least .5ml/kg/hr
MAP >65, UOP at least 4ml/kg/hr
MAP >75, UOP at least 1-2ml/kg/hr
MAP >50, UOP at least 2ml/kg/hr
Q.4
Epinephrine or Norepinephrine are vasopressors indicated for septic shock as push dose bumps or as infusions to support blood pressure.
True
False
Q.2
Would you release this patient to return home after you administered the first dose of antibiotics?
Yes
No
Maybe after teleconsult