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1. The systemic inflammation response syndrome includes which one of the following?

A. Decreased level of consciousness.

B. Decreased urine output.C. Evidence of bone marrow failure.

D. Hypotension.

E. Increased respiratory rate.2. This pro-inflammatory mediator is produced early in the onset of sepsis and reflect

the overactive status of inflammatory:

A. TNF-B. GM-CSF

C. IL-10

D. IL-4

E. IL-133. Which one of the following sepsis therapeutic strategies is not targeted to

inflammatory mediators or immune response?

A. Glukokortikoid

B. Intravenous immune globulinC. Soluble TNF receptor

D. Anti-endotoxin antibodyE. Drotrecogin Alfa

4. Which one of the following is leastlikely to be helpful in the initial management of a

child who presents with evidence of septic shock?

A. Blood glucose.B. Cerebrospinal fluid culture.

C. Renal function studies.

D. Serum electrolytes.E. Serum ionized calcium level.

Question 4 6 refer to the following case

A 10-year-old boy was admitted to the hospital with combustio (burned trauma). Patient

is using urine catheter. The patients vital signs are as follows: temperature 39oC, heartrate 135 bpm, respiratory rate 42 breaths/min, blood pressure 60/40 mmHg, and oxygen

saturation 98% without oxygen supplementation. A chest radiograph is normal. White

blood cell count is 20 x 103/uL and urine show 35-40 white cells/hpf. No other sources of

infection are identified.

5. This patients condition can best be defined as

A. multiple dysfunction syndromeB. sepsis

C. bacteremia

D. severe sepsisE. systemic inflammatory response syndrome

6. After ensuring adequate airway and oxygenation, what is the next step in the

management of this patient?

A. Antibiotic therapy

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B. -Blocker therapy to control heart rate

C. Intravenous fluid resuscitation

D. Surgical consult for gall bladder surgeryE. Vasopressor therapy with dopamine

7. The most possible source of infection in this patient is:

A. urinary tract infectionB. secondary infection of burned lesion

C. pulmonary infection

D. occult bacteremiaE. gastrointestinal infection

8. Which one of the following is leastlikely to be associated with sepsis in a young

child?

A. Delayed capillary refill.B. Lactic acidosis.

C. Normal blood pressure.

D. Normal temperature.

E. Tachycardia.9. If we find this clinical change (alone) in septic patient, we can diagnose him as

severe sepsis.A. Acute respiratory distress syndrome

B. Renal dysfunction

C. Hematologic dysfunction

D. Neurological dysfunctionE. Respiratory dysfunction

10. The true statement about sepsis:

A. During the onset of sepsis, the inflammatory system becomes hyporeactiveB. Lipopolysaccharide may contribute to Gram-negative sepsis

C. Nosocomial sepsis should be treated with a second-generation cephalosporin

D. Sepsis caused by H. influenzae may be associated with intravenous cathetersor surgical wounds

E. Sepsis without a focus has a much better prognosis than urosepsis.

11. Which of the following statements refers to sepsis?A. Infection must be proven

B. IL-1 and IL-6 activation can lead to pulmonary dysfunction through activation

of neutrophils that are attracted to lung tissue.

C. The sepsis response to a gram-negative organism begins with the release ofpeptidoglycan

D. The classic and alternate pathways of the complement system are activated by

antinflammatory cytokinesE. Release of TNF-, IL-1, and IL-6 stimulates the extrinsic coagulation cascade

and produces fibrin.