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Flashcards in Hypertension And Shock Deck (27):
1

Where can blood pressure be regulated?

Heart
Kidneys
Vasculature

2

Treatment of hypertension

Diuretics
Vasodilators eg alpha 1 R antagonist/ calcium blockers
ACE inhibitors - block angiotensin II and reduce aldosterone release
Beta blockers (phasing out)

3

What is blood pressure in hypertension?

Over 140/90

4

What is hypovolaemic shock?

Loss of circulating volume

5

After what blood loss will someone start to show signs of hypovolaemic shock

Reduction by 20-30%

6

Give some causes of hypovolaemic shock.

Hyponatraemia
Vomiting
Diarrhoea
Burns
Haemorrhage

7

Where are baroreceptors found?

Arch of aorta
Carotid sinus

8

What are the signs and symptoms of hypovolaemic shock?

Cold and clammy
Tachycardia
Weak pulse

9

What is the long term consequence of SNS stimulation in hypovolaemic shock?

Activation of the RAAS
ADH release

10

What effect does increased TPR have in hypovolaemic shock?

Impairs tissue perfusion (increase in vasodilator metabolites can override this)
Reduced hydrostatic pressure
Internal transfusion

11

What is anaphylactic shock?

A form of distributive shock caused by an allergic reaction

12

What chemical mediators can be released in anaphylactic shock?

Leukotrienes
Bradykinin
Histamine
Prostaglandins
Cytokines

13

What affect does histamine have in anaphylactic shock?

Decreased arterial blood pressure
Reduced TPR

14

What are the signs and symptoms of anaphylactic shock?

Dyspnea
Collapse
Tachycardia
Red and warm extremities
Fast and pounding pulse

15

How do you treat anaphylactic shock?

Adrenaline

16

What is toxic shock?

A form of distributive shock caused by sepsis.

17

What bacterial and endogenous chemicals contribute to the symptoms of toxic shock?

Endotoxin
TNF alpha
IL-1

18

What are the symptoms of toxic shock?

Tachycardia
Warm and red extremities
Strong pulse

19

How can you treat toxic shock?

Antibiotics
Fluid resuscitation with colloid

20

Give a cause of mechanical shock

Cardiac tamponade
Pulmonary embolism

21

What are the symptoms of mechanical shock

Dyspnoea
Chest pain
Raised JVP
Bulging neck veins
Tachycardia

22

What are the pressures in the right and left atria in mechanical shock caused by a pulmonary embolism?
(high or low)

Right - high
Left - low

23

What are the pressures in the right and left atria in mechanical shock caused by cardiac tamponade?
(high or low)

Right - high
Left - high

24

How would you treat cardiac tamponade?

Pericardiocentesis beneath the xiphoid process

25

What is cardiogenic shock?

Inability of the heart to eject enough blood

26

Give some causes of cardiogenic shock

Ventricular tachycardia
Bradycardia
MI which damages the left ventricle
Acute worsening of heart failure

27

How can cardiogenic shock cause oliguria?

Pressure is too low to filter blood through the kidneys