Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Vascular Surgery > 1: Acute Circulatory Failure/Shock > Flashcards

1: Acute Circulatory Failure/Shock Flashcards

1
Q

What is shock

A

Circulatory failure causing inadequate end-organ perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What blood pressure defines shock

A

Systolic BP <90 and MAP <65 with evidence of end-organ damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are 3 pieces of evidence of tissue hypo perfusion

A
  1. Urine output <0.5
  2. Mottled skin
  3. Serum lactate >2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How can the causes of shock be divided

A

Shock caused by:

  1. Decrease cardiac output
  2. Drop in systemic vascular resistance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the two types of shock due to inadequate cardiac output

A

Cardiogenic

Hypovolaemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the four types of shock due to decrease in systemic vascular resistance

A

Anaphylactic
Neurogenic
Distributive
Septic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How can shock be categorised

A

Class I - Class 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the following for class I shock

a. blood loss
b. HR
c. BP
d. RR
e. Urine output
f. behaviour

A

a. <750ml. (15%)
b. <100
c. Normal
d. Normal
e. >30
f. Anxious

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the following for class 2 shock

a. blood loss
b. HR
c. BP
d. RR
e. Urine output
f. behaviour
g. cap refill

A

a. 750-1000 (15-30%)
b. >100
c. Normal
d. 20-30
e. 20-30
f. anxious
g. >2s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the following for class 3 shock

a. blood loss
b. HR
c. BP
d. RR
e. Urine output
f. behaviour
g. cap refill

A

a. 1500-2000 (30-40%)
b. 120-140
c. Low systolic BP
d. >30
e. 5 - 20
f. Confused
g. >2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the following for class 4 shock

a. blood loss
b. HR
c. BP
d. RR
e. Urine output
f. behaviour
g. cap refill

A

a. >2000 (>40%)
b. >140
c. Unrecordable
d. >35
e. Negligible
f. Unresponsive
g. Absent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How much blood is lost in the following classes of shock

a. Class I
b. Class 2
c. Class 3
d. Class 4

A

a. <750ml
b. 750-1500
c. 1500-2000
d. >2000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What percentage of blood is lost in the following

A

a. 15%
b. 15-30%
c. 30-40%
d. >40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is mean arterial pressure calculated

A

MAP = CO x SVR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is hypovolaemic shock

A

Shock due to loss of more than 20% of circulating volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the two categories of hypovolaemic shock

A
  • Fluid Loss

- Blood Loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What blood loss could lead to hypovolaemic shock

A

Trauma
Ruptured AAA
GI Bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What fluid loss could lead to shock

A
  • Steven Johnson
  • Vomiting
  • Diarrhoea
  • Distributive: pancreatitis, burns
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Outline NICE resuscitation guidelines for managing shock

A
  1. A-E approach to identify individual is in shock
  2. 500ml resuscitation fluids over 15-minutes
  3. Re-assess using A-E
  4. 250-500ml bolus if no improvement
  5. If given 2L and no improvement, contact ICU
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Outline how much of the following individuals should have in maintenance fluids:

a. Water
b. Glucose
c. Sodium
d. Potassium
e. Chloride

A

a. 20-30ml/Kg/d
b. 50-100g/d
c. 1mmol/Kg/d
d. 1mmol/Kg/d
e. 1mmol/Kg/d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is cardiogenic shock

A

Shock due to cardiac dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How can aetiology of cariogenic shock be divided

A
  1. Obstructive

2. Non-obstructive

23
Q

What are the 5 causes of obstructive cardiogenic shock

A
  1. Constrictive pericarditis
  2. Tension pneumothorax
  3. Cardiac tamponade
  4. Restrictive cardiomyopathy
  5. PE
24
Q

What are the 2 causes of non-obstructive cardiogenic shock

A
  1. MI

2. Arrhythmias

25
Q

Explain management of cardiogenic shock

A
  1. Oxygen (94-98%)
  2. Diamoprhine
  3. Identify and treat cause
  4. Asses fluid status (JVP, BP, HR)

If under-filled: give crystalloid fluid resuscitation until MAP 70

If over-filled: give inotropic support using dobutamine until MAP 70

26
Q

What mean arterial pressure is aimed for in cariogenic shock

A

70

27
Q

Define sepsis

A

Life-threatening organ dysfunction caused by dysregulated immune response to infection

28
Q

Define septic shock

A

Sepsis w/

  • Lactate >2 despite fluid resuscitation
  • Requiring inotrope support to maintain MAP 65
29
Q

What causes sepsis

A

Infection

30
Q

What are 4 risk factors for sepsis

A
  • <1 or >75
  • Immunocompromised
  • ICU
  • Invasive medical procedure
31
Q

What is used to assess the risk of patients not in ITU of sepsis

A

qSOFA score

32
Q

What qSOFA score indicates a risk of sepsis

A

> 2

33
Q

What are the three aspects of the qSOFA score

A
  • Altered mental state
  • RR > 22
  • Systolic BP < 100
34
Q

What is used to assess the risk of sepsis in ITU patients

A

Full SOFA score

35
Q

What is the difference between septic shock and other forms of shock clinically

A

in septic shock the skin will be warm and flushed compared to other types where peripheries often cold.

36
Q

What are the red-flag criteria of sepsis set-out by NICE

A
  • V,P or U of AVPU
  • Acute confusional state
  • Systolic BP <90
  • HR >130
  • RR >25
  • Oxygen to maintain SpO2 >92
  • Non-blanching rash
  • Not passed urine in 18h
  • Lactate >2
  • On chemotherapy
37
Q

What are the amber-flag criteria set out by NICE for sepsis

A
  1. Relative concerned over mental state
  2. Acute deterioration in function
  3. Immunosuppressed
  4. Trauma or surgery in past 6W
  5. RR: 21-24
    6.BP 91-100
  6. HR 100-130 or new dysarrythmia
    8 No urine in 12-18h
  7. T <36
  8. Skin wound/Infection
38
Q

What is the sepsis 6 care bundle

A

Blood cultures

Urine output - measure hourly

Fluid - resuscitation protocol

Antibiotics

Lactate

Oxygen to maintain SpO2: 94-98

39
Q

What are the 4-criteria to contact ITU for septic shock

A
  1. RR > 25
  2. Systolic BP <100
  3. Altered consciousness
  4. Lactate remains high
40
Q

What is anaphylactic shock

A

type I IgE mediated hypersensitivity reaction

41
Q

What is an anaphylactoid reaction

A

release of mediators from mast cells without use of IgE antibodies

42
Q

How will anaphylaxis present

A
  • Itching
  • Bronchospasm
  • Angioedema
  • Tachycardia
  • Hypotension
43
Q

What should be measured following suspected anaphylactic reaction

A

serum tryptase

44
Q

What is the time-frame to measure serum tryptase

A

1-6h after anaphylactic reaction

45
Q

Outline management of anaphylaxis

A
  1. Secure airway: give oxygen if required and consider intubation
  2. IM adrenaline
  3. IV chlorphenamine
  4. IV hydrocortisone
  5. Fluid resuscitation
  6. If wheeze, manage as for asthma
46
Q

What dose of adrenaline is given and how

A

0.5mg IM

47
Q

After what time-frame is adrenaline repeated

A

Every 5-minutes

48
Q

What dose of chlorphenamine is given

A

10mg

49
Q

Whose dose of hydrocortisone is given

A

200mg

50
Q

If individual with anaphylaxis has a wheeze what is offered

A

Salbutamol

51
Q

If after initial management of anaphylaxis individual is still hypotensive what may be done

A

Admit ot ITU

52
Q

What could be given in ITU to manage anaphylaxis

A

IV adrenaline
Aminophylline
Nebulised salbutamol

53
Q

What dose of adrenaline is in epi-pens

A

0.3mg

Vascular Surgery (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions