Hemodynamic Disorders V

Question 1

infarction

Answer 1

death of tissue due to interruption in blood supply

Question 2

time until cellular death due to hypoxia of neuron

Answer 2

3-4 minutes

Question 3

time until cellular death of due to hypoxia of myocardium

Answer 3

20-30 minutes

Question 4

time until cellular death of fibroblast due to hypoxia

Answer 4

hours

Question 5

what is the typical shape of infartion

Answer 5

wedge-shaped

Question 6

When do you get a red (hemorrhagic) infart

Answer 6

venous occlusion
loose tissues
tissues w/dual circulation
tissues previously congested due to sluggish flow
re-established blood flow to a site of previous arterial occlusion and necrosis

Question 7

white (anemic) infart

Answer 7

typically of arterial occlusion in solid organs with limitation of blood flow into areas of ischemic necrosis

Question 8

what is the dominant histologic characteristic of infarction

Answer 8

ischemic coagulative necrosis

Question 9

how can you tell that an MI is several days old based on histology

Answer 9

dense polymorphonuclear leukocytic inflammatory infilitrate

Question 10

when do you get a septic infarct

Answer 10

when the origin of an embolus is infected tissue

Question 11

what is the major source of septic emboli

Answer 11

vegetations formed by bacteria growing on heart valves in bacterial endocarditis

Question 12

shock

Answer 12

inadequate blood flow secondary to decreased CO or maldistributed output that results in irreversible tissue damage

Question 13

sequela of shock

Answer 13

hypotension
impaired tissue perfusion
cellular hypoxia

Question 14

examples of things that can cause cardiogenic shock

Answer 14

infarction
arrythmia
tamponade
pulmonary embolism

Question 15

examples of things that can cause hypvolemic sshock

Answer 15

hemorrhage
fluid loss
burns
trauma

Question 16

examples of things that can cause septic shock

Answer 16

septicemia
systemic microbial infection
endotoxic shock

Question 17

neurogenic shock

Answer 17

neuogenic dysfunction causes loss of vascular tone and peripheral pooling of blood

Question 18

anaphylatic shock

Answer 18

generalized IgE mediated type I hypersentiviy reaction

Question 19

etiological classification

Answer 19

Septic
Spinal
Hypovolemic
Hemorrhagiv
Obstructive
Cardiogenic
Cellular toxin
Anaphylactic
Endocrine

Question 20

the 5 unifying features of shock

Answer 20

intracellular calcium overload
intracellular hydrogen ion
cellular and interstitial edema
catabolic metabolism
inflammation

Question 21

how many of the criteria do you need for shock in rosen’s empiric critiria

Answer 21

4 out of 6

Question 22

what is rosen’s empriic critia

Answer 22

ill apparence
HR >100
RR >22
acidic
deceased urine output
hypotension

Question 23

nonpregressive stage of shock

Answer 23

reflex compensation

mechanisms maintain tissue perfusion

Question 24

progressive stage of shock

Answer 24

worsening circulatory/metabolic imbalance

acidosis

Question 25

irreversible stage of shock

Answer 25

irreversible tissue damage

Question 26

what is cardiogenic shock

Answer 26

decreased CO and evidence of tissue hypoxia

Question 27

criteria for cardiogenic shock

Answer 27

hypotension 30 mmHG below baseline deceased cardiac output/SA increased PCWP

Question 28

how do you treat hemorrhagic shock

Answer 28

crystalloid bolus blood transfusion prn identify/treat cause

Question 29

advantages to colloids

Answer 29

less fluid required more volume in vascular space potential to draw fluid in from tissues

Question 30

disadvantages to colloids

Answer 30

expensive allergic reactions coagulopathies

Question 31

what cytokines are you going to see from first to last

Answer 31

LPS TNF IL-1 IL6/8

Question 32

sepsis

Answer 32

systemic inflammtory response syndrome + documented infection

Question 33

severe sepsis

Answer 33

sepsis + multi organ dysfunction

Question 34

septic shock

Answer 34

sepsis + hypotension refractory to volume resuscitation

Question 35

spinal shock

Answer 35

initial loss of spinal cord function following spinal cord injury

Question 36

why do you get hypotension due to neurogenic shock

Answer 36

loss of sympathetic tone, thus vasodilation and decreased SVR only occurs with lesions at or above T6

Question 37

why do you get bradycardia due to neurogenic shock

Answer 37

unopposed parasympathetic tone to heart

Question 38

when do yo usee neurogenic shock with bradycardia

Answer 38

lesions at or above T4