American Board of Family Medicine (ABFM) Practice Exam

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What differentiates severe sepsis from septic shock?

  1. Presence of organ dysfunction

  2. Hypotension refractory to IV fluids

  3. High WBC count

  4. Fever and chills

The correct answer is: Presence of organ dysfunction

Severe sepsis is characterized by the presence of organ dysfunction resulting from a systemic inflammatory response to an infection. This dysfunction can manifest as impaired respiratory, renal, hepatic, or cardiovascular function, or other organ systems being affected. The key distinction in this context is that severe sepsis indicates that there is already a significant impact on body systems due to the infectious process. On the other hand, septic shock represents a more advanced stage of sepsis, defined primarily by the occurrence of persistent hypotension that does not improve with adequate fluid resuscitation. While organ dysfunction is indeed present in both severe sepsis and septic shock, the hallmark of septic shock is this level of hypotension and the more critical state of the patient. While elevated white blood cell counts, fever, and chills can be associated with infections and sepsis, they do not specifically differentiate between severe sepsis and septic shock in the way that the presence of organ dysfunction does. Therefore, understanding the criteria and definitions around these classifications is crucial for proper diagnosis and treatment.