Schock

Question 1

Shock is also called….
It occurs when ……
Lead to….
It is classified by the ….

Answer 1

hypoperfusion
circulating blood volume is decreased and doesnt reach tissues
decreased tissue perfusion
cause

Question 2

Hypovolemic shock is due to …. of circulating blood.
Causes
Four stages:

Answer 2

decrease in volume
hemorrhage, burns, severe dehydration, peritonitis 
1-up to 15% BV lost
2-15-30% BV lost
3-30-40% BV lost
4-over 40% BV lost

Question 3

Cardiogenic shock is due to the ….
Causes
Subcategory…

Answer 3

inability of heart to maintain cardiac output to circulation (decreased pumping capability)
weakening of the heart
obstructive cardiogenic shock

Question 4

Obstructive cardiogenic shock is due to … and results from

Answer 4

physical obstruction of circulation either into or out of the heart
cardiac tamponade, pulmonary embolism, narrowing of the aorta

Question 5

Distributive or vasogenic shock is due to …..

Three types…

Answer 5

relocation of blood to periphery (from systemic vasodilation)

Septic, anaphylactic, neurogenic

Question 6

Septic shock is an ….. which causes…

Example

Answer 6

overwhelming infection
systemic vasodilation
E coli endotoxin LPS (lipopolysaccharide)

Question 7

Anaphylactic shock is a ….

Type …. hypersensitivity

Answer 7

severe allergic reaction

I

Question 8

Neurogenic shock is the… its due to…. which loosens the blood vessel tone and …. vessel walls and causes vasodilation.

Answer 8

rarest
damage of CNS
relaxes

Question 9

Causes of neurogenic shock

Answer 9

trauma (SCI)
metabolic dysfunction
pain
fear
drugs

Question 10

Pathophysiology of shock is inadequate…. lack of….lack of ….resulting in ….accumulation of…

Answer 10

tissue perfusion
nutrients
oxygen
cellular ischemia
wasts

Question 11

During shock cells switch to … respiration because of depletion of …. and lactic acid build up. …pump also fails.

Answer 11

anaerobic respiration
ATP
Sodium potassium

Question 12

Compensation mechanisms activated with BP is ….
SNS is stimulated to cause …..
Hormone secretion is increased in …..
Kidneys increase their secretion of …
Lungs increase respiration which is stimulated by…

Answer 12

decreased
increase HR and force of contraction, systemic vasoconstriction
aldosterone (BV increases by increasing reabsorption of sodium and water), ADH (increasing blood volume and vasoconstriction)
renin (vasoconstriction)
acidosis

Question 13

As shock progresses… occurs.

…becomes more severe causing decreased blood flow, more ischemia, and more acidosis.

Answer 13

decompensation

vasoconstriction

Question 14

Cytokines from dead cells are released as shock progresses which causes …..

Answer 14

fluid to shift from blood to interstitial space, multiple organ failure and death

Question 15

First signs of shock and SNS stimulation by low BP?

Compensation signs?

Answer 15

thirst, agitation, anxiety and restlessness

Tachycardia, oliguria

Question 16

Complications of shock in kidneys?
respiratory?
liver?
GI?
cardiac?
vascular?

Answer 16

acute renal failure from tubular necrosis
ARDS from blood fluid with proteins leak into alveoli
hepatic failure from hepatocyte necrosis
GI ulceration
depressed cardiac function due to acidosis
DIC when clotting is initiated

Question 17

Treatment for shock:

Answer 17

Primary cause must be treated

Question 18

Treatment for hypovolemic shock?
anaphylactic shock?
septic shock?

Answer 18

Blood or substitute infusion
antihistamines, corticosteroids
antimicrobials, corticosteroids

Question 19

During shock treatments, we want to maximize …. supply.

Use … or … to increase BP and dilate renal BV respectively.

Answer 19

oxygen

vasoconstrictors or vasodilators