FCCS FCCS Sepsis and Infection Control 1 — Questions and Answers
Question 1: Sepsis-3 defines sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection, identified clinically by a SOFA score change of how many points?
- ≥ 1 point
- ≥ 2 points (Correct answer)
- ≥ 3 points
- ≥ 4 points
Correct answer: ≥ 2 points
Sepsis-3 criteria use an acute SOFA score increase of ≥ 2 points to identify organ dysfunction associated with infection.
Question 2: What is the recommended blood culture timing relative to antibiotic administration in septic shock?
- Cultures must be drawn 1 hour after antibiotics
- Cultures drawn before antibiotics if possible, but antibiotics should NOT be delayed > 1 hour (Correct answer)
- Cultures are not needed before antibiotics
- Cultures should be drawn 24 hours after antibiotics
Correct answer: Cultures drawn before antibiotics if possible, but antibiotics should NOT be delayed > 1 hour
Blood cultures should be obtained before antibiotics when possible, but initiating antibiotics within 1 hour of septic shock recognition takes priority over culture timing.
Question 3: The Surviving Sepsis Campaign recommends completing a 30 mL/kg IV crystalloid bolus within how many hours of septic shock?
- 6 hours
- 3 hours (Correct answer)
- 1 hour
- 12 hours
Correct answer: 3 hours
The Surviving Sepsis Campaign Hour-1 Bundle recommends administering at least 30 mL/kg IV crystalloid within 3 hours of septic shock identification.
Question 4: Which biomarker is most useful for monitoring antibiotic response and guiding de-escalation in sepsis?
- White blood cell count
- Procalcitonin (PCT) (Correct answer)
- C-reactive protein (CRP)
- Lactate
Correct answer: Procalcitonin (PCT)
Serial procalcitonin levels fall with effective antibiotic therapy, and PCT-guided de-escalation reduces antibiotic duration without worsening outcomes.
Question 5: A lactate level > 4 mmol/L in a suspected infection patient meets criteria for which condition regardless of blood pressure?
- Severe sepsis (old terminology)
- Septic shock (Sepsis-3 criteria) (Correct answer)
- SIRS only
- Bacteremia
Correct answer: Septic shock (Sepsis-3 criteria)
Sepsis-3 defines septic shock as sepsis plus either vasopressor requirement to maintain MAP ≥ 65 or lactate > 2 mmol/L; lactate > 4 mmol/L alone strongly indicates high mortality risk equivalent to shock.
Question 6: Which antibiotic combination provides both gram-negative and MRSA coverage for empiric septic shock therapy?
- Amoxicillin + metronidazole
- Vancomycin + piperacillin-tazobactam or meropenem (Correct answer)
- Ciprofloxacin + clindamycin
- Azithromycin + ceftriaxone
Correct answer: Vancomycin + piperacillin-tazobactam or meropenem
Vancomycin covers MRSA and gram-positive organisms, while piperacillin-tazobactam or meropenem covers broad gram-negative pathogens including Pseudomonas.
FCCS FCCS Sepsis and Infection Control 1
Sepsis-3 defines sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection, identified clinically by a SOFA score change of how many points?