IDENTIFICATION
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1. According to current Sepsis-3 updates, what is the definition of sepsis?
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A) An infection that evolved with uncorrected hypotension with volume replacement, irrespective of lactate changes; |
B) Suspected or confirmed infection, without organic dysfunction, irrespective of the presence of signs of Systemic inflammatory response syndrome; |
C) Presence of life-threatening organic dysfunction secondary to the body’s unregulated response to infection; |
D) Suspected or confirmed infection without organic dysfunction; |
E) Infection characterized by the presence of at least two of the following clinical criteria: 1) body temperature >38°C or <36°C; 2) respiratory rate >20 breaths per minute or a partial pressure of CO2 in arterial blood <32 mmHg; 3) heart rate >90 beats per minute; 4) significant increase or decrease in the number of white cells (leukocytes) in peripheral blood (>12.000 or <4.000 cells/mm3), or presence of more than 10% of young leukocytes (band cells). |
2. From the alternatives below, which one contains only organ dysfunctions potentially caused by sepsis? (Select only one alternative)
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A) Hyperemia, hypotension, oliguria, and platelets <100,000/mm3 or decrease in 50% in the number of platelets in relation to the highest value recorded in the last 3 days. |
B) Decreased level of consciousness, hypotension, hyperlactatemia, and PaO2/FiO2 ratio <300. |
C) Significant increase in bilirubin, hypolactatemia, altered level of consciousness, and hypotension. |
D) Oliguria, hematoma, hypotension, and platelets <100,000/mm3 or decrease in 50% in the number of platelets in relation to the highest value recorded in the last 3 days. |
E) All alternatives are correct. |
3. From the alternatives below, which one correctly presents the three components of the qSOFA Score?
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A) Glasgow coma scale <15, respiratory rate ≥22 bpm, and systolic blood pressure <100 mmHg. |
B) Decreased level of consciousness, oliguria, and azotemia. |
C) Systolic blood pressure <100 mmHg, hyperlactatemia, and thrombocytopenia. |
D) Systolic blood pressure <90 mmHg, metabolic acidosis, and hyperbilirubinemia. |
E) Glasgow coma scale <15, hyperlactatemia and respiratory rate ≥ 22 bpm. |
TREATMENT AND MANAGEMENT
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4. A 70 kg patient – diagnosed with sepsis, hypotension, and signs of hypoperfusion – received volume resuscitation of 1,400 ml of 0.9% saline. Is the volume infused in accordance with the guidelines for immediate volume replacement?
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( ) Yes (X) No ( ) Does not know |
5. The use of vasopressors is indicated for patients who remain with average blood pressure ≤75 mmHg (during or after infusion of volume), noradrenaline being the drug of first choice.
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( ) Yes (X) No ( ) Does not know |
6. Is the recommended time for initiation of intravenous antimicrobial therapy up to one hour after the recognition of sepsis and septic shock?
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(X) Yes ( ) No ( ) Does not know |
7. Protein colloids, albumin, and albumin serum are contraindicated as initial resuscitation fluids.
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( ) Yes (X) No ( ) Does not know |
8. Should blood from two different sites be collected in all viable patients with suspected sepsis?
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(X) Yes ( ) No ( ) Does not know |
9. Is the use of bicarbonate contraindicated in cases of lactic acidosis in patients with pH>7.15?
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(X) Yes ( ) No ( ) Does not know |
10. Select the alternative that contains the perfusion parameters that can be reevaluated after volume resuscitation.
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A) Level of consciousness, diuresis, temperature, and vena cava distensibility. |
B) Measurement of central venous saturation, respiratory rate, capillary filling time, and diuresis. |
C) Pulse pressure variation, vena cava distensibility, lactate level, and level of consciousness. |
D) Capillary filling time, elevated creatinine, elevated blood pressure, and O2 saturation. |
E) All alternatives are correct |