EXAM #2: SHOCK Flashcards Preview

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Flashcards in EXAM #2: SHOCK Deck (14)
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1
Q

What is shock?

A

Inability to maintain perfusion

2
Q

What are the four components of tissue perfusion?

A

1) Cardiac function
2) Arterial pressure
3) Vascular function
4) Cellular function i.e. oxygen delivery

3
Q

What are the three major categories of circulatory shock?

A

1) Cardiogenic
2) Hypovolemic
3) Distributive

4
Q

What is cardiogenic shock?

A

Markedly reduced contractility/CO e.g. from acute MI

*Does not have to be STEMI

5
Q

What is hypovolemic shock?

A

Shock that results from a loss of blood volume e.g.

  • Hemorrhage
  • Severe burn
6
Q

What is distributive shock?

A

Generally, an abnormal shunting of blood e.g. sepsis

*Note that the CO may be HIGH in an attempt to compensate (trying to fill a tank that is too big)

7
Q

How does sepsis cause distributive shock?

A

Sepsis causes widespread vasodilation

8
Q

What is the general feature of shock?

A

Very low systolic arterial blood pressure (less than 60 mmHg)

9
Q

What is the classic etiology of cardiogenic shock?

A

Loss of large amount/function of myocardial contractile tissue

*AMI, dilated cardiomyopathy, valvular defect, arrhythmia

10
Q

Most is the most important indicator of prognosis in cardiogenic shock?

A

LV function

Note that this is true for ANY heart disease

11
Q

What are the consequences of shock?

A

1) Multiorgan dysfunction
2) Acidemia
3) Myocardial dysfunction
4) ARDS
5) ATN (Acute Tubular Necrosis)
6) GI
- Hepatic injury/ “shock-liver
- Intestinal ischemia/injury
7) CNS

12
Q

What is the effect of acidemia on cardiac function?

A

Acidemia decrease myocardial function

13
Q

What are the most important features of shock management?

A

1) ICU care
2) Oxygen supplementation
3) ABGs to manage acid-base status

14
Q

What kind of fluid should be used for volume expansion in shock?

A

Isotonic (NS or LR)