Septic Shock – Board-Style Questions

What this deck covers

Septic shock in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Sleepy with the fever
2. After the fluid has run
3. Cold hands, fast heart
4. A number that weakens the pump
5. The sugar on the gas
6. The count after the storm
7. Putting the tube in
8. Still needing the drip
9. The plate comes back
10. Still hot on day two
11. Feeding on the unit
12. A bundle from a journal
13. Nothing is working
14. Tiring on the mask
15. Home after intensive care
16. Catching it at the door
17. A rising creatinine
18. The child with a line

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: The heart rate of 175 beats/min at triage, An adrenaline infusion, preferred to dopamine in children, A repeat blood pressure reading taken in ten minutes, The albumin, which could be replaced by an infusion, Watch it, since aiming for a tight figure causes harm, Transfuse now to bring it up above 100 g/L, Propofol, given slowly and in a much reduced dose, A further day of the same treatment before acting again, Change to the agent the organism is sensitive to, Cool her actively so that she stays below 37 degrees, Nutrition by vein from the first day onwards, It should be started at once in every child, Mechanical support of the circulation itself, Continue with the mask and watch him closely tonight.

Clinical pearls from this deck

• A falling conscious level with fever is organ failure.
• Adrenaline comes before dopamine in a child with sepsis.
• Look at the heart before you choose the next drug.
• A low ionised calcium weakens the heart in sepsis.
• Chasing a normal sugar in sepsis harms the child.
• Stable after sepsis: transfuse below seventy, not before.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all emergency and critical care case decks · pediatric reference values.