Learning Activities

Question 1

MAP =

Answer 1

CO x SVR

Question 2

SVR x CO =

Answer 2

MAP

Question 3

blood vessel tone, or systemic vascular resistance is related to which bp?

Answer 3

diastolic

Question 4

in terms of blood vessel tone, what happens to the vessels when tone goes up?

when tone goes down?

Answer 4

when tone goes up - -> vasoconstriction

when toes goes down - - > vasodilation

Question 5

what happens to diastole during vasodilation?

Answer 5

diastolic bp number goes down

Question 6

what happens to diastole during vasoconstriction?

Answer 6

diastolic bp number goes up

Question 7

what happens to the pulse P when cardiac output goes up?

Answer 7

the pulse pressure widens

Question 8

what happens to pulse P when cardiac output goes down?

Answer 8

the pulse pressure narrows

Question 9

what is the shock index?

Answer 9

it is the HR divided by systolic bp

sys bp

Question 10

what is a positive shock index?

Answer 10

HR
—– > 1
sys bp

this is bad….

Question 11

all forms of shock elevate the ______

Answer 11

lactate

higher lactic acid –> higher mortality

Question 12

name two problems that result from problems with contractility, and what class of treatments are used

Answer 12

MI
CHF

(inotropes are used for treatment)

Question 13

what two types of problems result from preload problems

Answer 13

type 1 - decreased volume

type 2 - obstructive problems

Question 14

name four types of decreased volume-type problems for preload

Answer 14

dehydration
diarrhea
diuresis
hemorrhage

Question 15

name the types of obstructive problems for preload

Answer 15

RV: pneumothorax and pericardial tamponade

LV: PE

Question 16

name the four classic names of shock

Answer 16

distributive
cardiogenic
hypovolemic
obstructive

Question 17

name the three ways of recognizing shock

Answer 17

frank shock (map < 65)

occult shock (it’s tricky, and hiding….RELATIVE hypotension, watch that lactic acid!)

shock index (when it’s positive, it’s bad)

Question 18

name five conditions or injuries that affect systemic vascular resistance leading to distributive shock

Answer 18

sepsis
anaphylaxis
spinal trauma
anesthesia
Addison's

Question 19

what is the treatment for shock, when the problem is with the heart rate?

Answer 19

electricity

too fast - shock
too slow - pace

Question 20

what is the treatment for shock, when the problem is with contractility (i.e. CHF)?

Answer 20

inotropes

milrinone
dobutamine

Question 21

what is the treatment for shock when the problem is with systemic vascular resistance, specifically in the case of sepsis?

Answer 21

inoconstrictors

NE
dopamine

Question 22

what is the treatment for treatment for shock when the problem is with systemic vascular resistance, specifically from causes other than sepsis?

Answer 22

vasoconstrictors

epinephrine
vasopressin
phenylephrine

Question 23

what is the treatment for shock when the problem is a volume depletion?

Answer 23

volume

IVF
blood