Hematology and Immunology Flashcards

A septic patient develops warm flushed skin, hypotension, and bounding pulses early in the course. This reflects which phase?

Answer: Hyperdynamic (warm) phase of septic shock

Early warm septic shock causes vasodilation with warm skin, bounding pulses, and a high cardiac output before progressing to the cold phase.

Which intervention is the priority within the first hour of recognizing sepsis (sepsis bundle)?

Answer: Obtain lactate, blood cultures, and begin fluids plus broad-spectrum antibiotics

The hour-1 sepsis bundle includes measuring lactate, drawing cultures before antibiotics, starting fluids, and giving broad-spectrum antibiotics.

Which serum lactate level is a marker of tissue hypoperfusion in sepsis?

Answer: Greater than 2 mmol/L

An elevated lactate, particularly above 2 mmol/L, indicates anaerobic metabolism and tissue hypoperfusion in sepsis.

A patient with HIV has a CD4 count of 180 cells/mm3. This indicates the patient is at risk for what?

Answer: Opportunistic infections such as Pneumocystis pneumonia

A CD4 count below 200 cells/mm3 defines AIDS and greatly increases the risk of opportunistic infections like PCP.

Which intervention reduces infection risk most effectively for an immunocompromised patient?

Answer: Strict hand hygiene by all caregivers

Meticulous hand hygiene is the single most effective measure to prevent infection in immunocompromised patients.

A patient receiving a massive transfusion is at risk for which electrolyte abnormality from citrate in stored blood?

Answer: Hypocalcemia

Citrate used as an anticoagulant in stored blood binds calcium, causing hypocalcemia during massive transfusion.

Which type of immunity is provided by administration of intravenous immunoglobulin (IVIG)?

Answer: Passive immunity

IVIG supplies preformed antibodies, conferring immediate but temporary passive immunity.