A 45-year-old woman presents to the emergency room with altered mental status. On physical examination, her temperature is 102°F, pulse is 120/mm, and respirations are 24/mm. She has increased fremitus and bronchial breath sounds at the left base. Neurologic exam reveals no focal deficits, but the patient is disoriented to place and time. Chest radiograph confirms the diagnosis of pneumonia. The patient’s PACO2 is 30 mmHg. Which of the following best categorizes this patient’s illness?
A. The patient has bactererniaB. The patient has systemic inflammatory response syndrome
C. The patient has sepsis
D. The patient has severe sepsis
Answer. D. The patient has severe sepsis
Classsical deifinition based MCQ’s related to topic:
Bacteremia is the presence of
bacteria in blood culture bottles. SIRS
(systemic inflammatory response syndrome) is not a diagnosis but a response to
a variety of clinical situations (i.e., infection, burns, trauma, pancreatitis)
and is characterized by two or more of the following:
(1) temperature of >100.5°F
or <97°F,
(2) heart rate of > 90/min,
(3) respiratory rate of
>20/min
(4) Paco2 of <32 mmHg,
(5) white blood cell count
of>l2,000/-Q or <4,000/PL or >10% immature (band) forms.
Sepsis is a systemic response
to infection manifested by two of the five described conditions of SIRS.
Severe sepsis is sepsis
associated with organ dysfunction, hypoperfusion, or hypotension (i.e., lactic
acidosis, oliguria, altered mental status). Septic shock is sepsis-induced hypotension despite adequate fluid
resuscitation.
Sepsis- induced hypotension is
a systolic blood pressure of<90 mmHg or a reduction of>40 mmHg from
baseline in the absence of other causes to explain the hypotension.
MODS is the presence of organ
dysfunction in an acutely ill patient such that homeostasis cannot be
maintained without intervention.
