Septic Shock

Question 1

what is shock?

Answer 1

Is generalized reduced perfusion ( hypoperfusion) of tissues with blood - which results in impaired oxygenation of tissues.

Question 2

why does shock occur?

Answer 2

Reduced cardiac output

Reduced blood volume

Reduced vascular tone

Question 3

shock can result in what?

Answer 3

hypotension -> impaired tissue perfusion -> cellular hypoxia -> multiple organ failure.

Question 4

what are the different types of shock?

Answer 4

1. Hypovolemic**
2. Cardiogenic**
3. Septic (endotoxic) shock*****
4. Neurogenic
5. Anaphylactic shock

Question 5

what is Most common type of shock with highest mortality?

Answer 5

Septic shock*

Question 6

why does septic shock occur?

Answer 6

Due to overwhelming microbial infection

Question 7

what microbe is the most common at causing septic shock? with what do they cause septic shock?

Answer 7

Gram negative septicemia*, Most cases caused by endotoxin producing gram-negative bacteria

Question 8

what are all the most common causes of septic shock?

Answer 8

1. E.coli sepsis (from indwelling urinary cathete)
2. Urinary retention
3. Spread of localized infection to blood stream:

Question 9

what is the pathogenesis of septic shock?

Answer 9

1. Endotoxins are component of cell wall of gram negative bacteria and are lipopolysacchrides (LPS)
2. These are released when bacterial cell wall is degraded.
3. The endotoxins bind to CD14 receptor on WBC and endothelial cells causing septic shock