The question asks to identify the characteristic that is NOT part of Systemic Inflammatory Response Syndrome (SIRS). SIRS is defined by a set of clinical signs indicating a widespread inflammatory state. Let's analyze the options based on the established SIRS criteria.
SIRS Criteria Analysis
The typical criteria for SIRS include at least two of the following:
- Temperature: Core body temperature < 36°C or > 38°C.
- Heart Rate (Tachycardia): Heart rate > 90 beats per minute.
- Respiratory Rate (Tachypnoea): Respiratory rate > 20 breaths per minute or partial pressure of carbon dioxide (<$ \text{PaCO}_2 $) < 32 mmHg.
- White Blood Cell (WBC) Count: WBC count < 4,000 cells/mm³ or > 12,000 cells/mm³, or immature neutrophils (bands) > 10%.
Evaluating the Options
- Option 1: Release of lipopolysaccharide endotoxins... This describes a potential trigger or cause of SIRS, particularly in infections caused by Gram-negative bacteria. It is not a clinical manifestation or criterion of SIRS itself.
- Option 2: Tachycardia with a heart rate of more than $90/\text{min}$ This aligns directly with one of the standard SIRS criteria.
- Option 3: White cell count $< 5000/\text{mm}^3$ This represents leukopenia, which is included in the WBC count criteria for SIRS (along with leukocytosis).
- Option 4: Tachypnoea with a respiratory rate of $> 20/\text{min}$ This aligns directly with one of the standard SIRS criteria.
Conclusion on SIRS Exception
Options 2, 3, and 4 represent physiological signs that are part of the diagnostic criteria for SIRS. Option 1 describes a causative factor, not a clinical characteristic of the syndrome itself. Therefore, the release of lipopolysaccharide endotoxins is the exception.
Important Questions from Types of Shock & Treatment
Which of the following are correct in respect of Systemic Inflammatory Response Syndrome (SIRS)?
1. It is caused by the release of lipopolysaccharide endotoxin from dying $E. coli$ bacteria.
2. It is same as bacteraemia.
3. It results in Multiple Organ Dysfunction Syndrome (MODS).
4. White cell counts of more than $12\times10^9$/litre are present.
Select the answer using the code given below.
Distributive shock is described by which of the following patterns of cardio- vascular responses?
1. Vasodilation
2. Reduced resistance peripheral vascular
3. Inadequate 'afterload'
4. Low cardiac output
Select the correct answer using the code given below.
- The best measure of organ perfusion and the best monitor of adequacy of shock therapy is
- The capillary refill time is prolonged in all types of shock EXCEPT:
- The following are features of hypovolemic shock except:
