Edema and Shock --> includes Starling Forces (5 star!!!) Flashcards Preview

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Flashcards in Edema and Shock --> includes Starling Forces (5 star!!!) Deck (28):
1

what is Pc?

pulmonary capillary pressure--> pushes fluid out of capillary

2

what is Pi?

interstitial fluid pressure⇒ pushes fluid into capillary

3

What is πc?

plasma colloid osmotic pressure (in capillary) ⇒ pulls fluid into capillary

4

what is πi?

interstitial fluid colloid osmotic pressure ⇒ pulls fluid out of capillary

5

what is Kf?

filtration constant ➡ reflects capillary permeability

6

what four things can cause ↑ Kf?

1. infections
2. septic shock
3. toxins
4. burns

7

where does most filtration take place in the capillary

at the arterial side ⇒ higher Pc and πi pull fluid out; by the venous end, fluid has left the capillary and a higher relative πc serves to keep fluid in the capillary

8

what are three conditions ↑ Pc might be seen in

1. CHF (congestion in capillaries)
2. Venous thrombosis
3. Compression of veins

9

4 conditions ↓ πc might be seen

1. Nephrotic syndrome
2. Liver Dz
3. Protein malnutrition
4. Protein losing enteropathy

10

what can cause ↑ πi

Lymphatic occlusion ⇒ (can be due to tumor, surgery, infection or radiation)

11

what happens to SVR and CO in hypvolemic shock

↓ CO w/ compens. ↑ SVR

12

Tx for hypovolemic shock

IV fluids/ transfusion

13

SVR and CO in cardiogenic shock?

↓ CO w/ compens. ↑ SVR

14

SVR and CO in sepsis/ anaphylaxis

↓ SVR w/ compens. ↑ CO (increased HR, sypathetic d.c fro drop in BP)

15

earliest sign of septic shock?

Tachycardia --> can be complicated by multiorgan failure; ischemia may lead to lactic acidosis

16

SVR and CO in neurogenic shock? causes?

both ↓; due to brain or spinal cord injury

17

Tx for cardiogenic shock? (1)

Dobutamine ⇒ inotropic agent (β1 agonist)

18

tx for septic shock (3)

1. ABx
2. IV fluids
3. NE!

*remember, NE is the best vasopressor for spetic shock shock; Epi is for anaphylactic shock

19

what tx is needed for spinal cord injury other than IV fluids to maintain CO

high dose steroids

20

MCC of hypovolemic shock? what is another big cause

1. MCC = blood loss
2. Burns - also cause massive fluid loss

21

7 causes of cardiogenic shock

1. MI
2. pulmonary embolism (PE)
3. CHF
4. tension pneumothorax
5. cardiac tamponade
6. cardiac contusion
7. Arrhythmia ( v-tach or v-fib)

22

central line placement with highest risk of pneumothorax

subclavian

23

why do you not place a internal jugular central line in the left IJ

greater risk of perforating the left SC vein due to the angle at which the left IF and left SC meet

*risk of puncturing the carotid with these too

24

placement for Swan-Getz catheter

right IJ or left SC

25

what is a way to tell from physical exam if a pt is in cardiogenic or septic shock

Cardiogenic --> skin will be cold, clammy, cyanotic

Septic--> skin will be warm and red (due to increased vascular permeability/ vasodilation)

26

pitting edema is what kind of fluid

transudate (no colloid) ⇒ due to ↑Pc or ↓πc

27

non-pitting edema is what kind of fluid

exudate--> doesnt pit b/c protein rich ⇒ due to ↑Kf = infections, septic shock, toxins, burns

28

what is a potential issue with femoral central lines, although the easiest to place and least risk of complication

can only stay in for 5-7 days due to risk of infection

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