CPEN Sepsis and Infectious Disease Emergencies

Question 1

According to current Surviving Sepsis Campaign guidelines for pediatrics, what is the recommended time frame for administering IV antibiotics after recognizing septic shock?

Accepted Answer

Within 1 hour

Answer

Within 3 hours

Answer

Within 6 hours

Answer

Within 30 minutes

Question 2

A 6-month-old presents with temperature of 38.5°C, heart rate of 180 bpm, respiratory rate of 55, and appears lethargic. What is the MOST appropriate initial intervention?

Accepted Answer

Obtain blood cultures and start broad-spectrum antibiotics

Answer

Perform a lumbar puncture immediately before any other action

Answer

Administer antipyretics and observe for 30 minutes

Answer

Order chest X-ray and urinalysis only before treatment

Question 3

What is the recommended initial fluid bolus for a pediatric patient presenting in septic shock?

Accepted Answer

20 mL/kg of isotonic crystalloid

Answer

5 mL/kg of 0.9% normal saline

Answer

10 mL/kg of 5% dextrose in water

Answer

40 mL/kg of 0.45% half-normal saline

Question 4

Which laboratory finding is MOST consistent with severe sepsis and tissue hypoperfusion?

Accepted Answer

Elevated serum lactate level greater than 2 mmol/L

Answer

White blood cell count below 5,000/mm³ only

Answer

Blood glucose above 200 mg/dL

Answer

Normal C-reactive protein with elevated procalcitonin

Question 5

A 2-year-old with septic shock receives three fluid boluses totaling 60 mL/kg with minimal hemodynamic improvement. What is the NEXT most appropriate intervention?

Accepted Answer

Initiate vasoactive medications such as epinephrine or norepinephrine

Answer

Administer a fourth fluid bolus of 20 mL/kg

Answer

Perform immediate endotracheal intubation without other interventions

Answer

Transfer without further intervention

Question 6

Which presentation BEST describes 'warm shock' (hyperdynamic septic shock) in a pediatric patient?

Accepted Answer

Bounding pulses, flash capillary refill, and wide pulse pressure

Answer

Cool, mottled skin with weak thready pulses and delayed capillary refill

Answer

Bradycardia with absent peripheral pulses and cold extremities

Answer

Cyanosis with agonal respirations and pulseless rhythm

Question 7

A febrile neonate aged 18 days is brought to the emergency department. The infant appears well but has a rectal temperature of 38.1°C. What is the MOST appropriate management?

Accepted Answer

Perform full sepsis workup and admit for empiric IV antibiotics

Answer

Observe for 4 hours and discharge if remains well-appearing

Answer

Administer oral amoxicillin and recheck in 24 hours

Answer

Obtain urinalysis and CBC only before making treatment decision