Flashcards in Common ICU Pathologies Deck (38)
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1
______ = poor distribution of blood at the microcirculatory level
shock
2
4 types of shock?
1. hypovolemic
2. cariogenic
3. distributive
4. miscellaneous
3
_______ shock = blood loss
hypovolemic
4
_______ shock = heart damage
cardiogenic
5
3 types of distributive shock?
1. septic
2. anaphylactic
3. neurogenic
6
_____ = life threatening condition that arises when the bodies response to an infection injures its own tissues and organs
sepsis
7
Sepsis occurs when the release of __________ _______ in response to an infection exceeds the boundaries of the local environment, leading to a more _______ response
proinflammatory mediators; generalized
8
3 symptoms in the quick sepsis related organ failure assessments (qSofa)?
1. resp rate >/= 22 minute
2. altered mentation (GCS <15, RASS < 0)
3. systolic BP = 100mmHg
9
Pt's are defined as septic if they have a score of < or = to ___ on the SOFA
2
10
Pt's with septic shock can be identified with a clinical construct of sepsis with what 2 things?
1. persistent hypotension requiring vasopressors to maintain MAP >/= to 65mmHg despite adequate circulating volume (aka not hypovolemic)
2. serum lactate level >2mmol/L despite adequate volume resuscitation
11
In septic shock, immune system spirals out of control; normal response to infection is local, but in septic shock the inflammatory response occurs systematically causing widespread _______ and vascular _______
vasodilation; permeability
12
Sepsis hospital mortality is in excess of __%
40
13
Common complication of septic shock?
ARDS
14
_____ ____ ____ = presence of altered organ function / altered systems in acutely ill individuals
multiple organ failure (/dysfunction syndrome)
15
In many pts sepsis can lead to significant ____ _____
brain injury
16
Typically MAP must be kept over ____
65
17
Fluids used to treat sepsis include colloids, crystalloids, starches and high chloride (T/F)
FASLE; just colloids and crystalloids
18
Vasopressors should be used __-__ hours after onset of sepsis
1-6
19
Pts with sepsis should be placed in deep sedation immediately at onset (T/F)
FALSE; no deep sedation
20
_____ = severe form of acute lung injury that occurs when there is trauma to the lungs leading to inflammation and fluid build up in lungs
ARDS
21
Essential pathophysiology of ARDS is increased pulmonary ______ ______
microvascular permeability
22
In ARDS, a diffuse inflammatory reaction occurs and fluid leads from circulating _____ into lung tissue
blood
23
In ARDS, ______ fills up alveoli; excess alveolar fluid mixes with normal lung ________ and can destabilize the alveoli, allowing them to collapse leading to impaired gas exchange and resp failure
edema; surfactant
24
ARDS damage to elastic tissue creates a _____ lung ;______ membranes (scarring) forms in alveoli which impairs gas exchange further
stiff; hyaline
25
Onset of ARDS must be acute as defined within ___ days of some defined event (often sepsis or shock related)
7
26
Most ARDS occurs within __ hours of recognition of presumed trigger
72
27
Bilateral opacities consisted with pulmonary oedema must be present on CT or CXR for dx of ARDS (T/F)
TRUE
28
3 dx criteria for ARDS?
1. onset
2. pulmonary edema
3. resp failure not explained by cardiac or fluid overload
29
3 treatments for ARDS?
1. intubation
2. pharmacological management of underlying trigger
3. prone positioning
30
