Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

SAMS 1 > Lecture 9: Shock II and III > Flashcards

Lecture 9: Shock II and III Flashcards

1
Q

What is the goal in dx shock

A

determine extent of organ injury and identify cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what initial dx do you want to do for suspected shock

A
  1. Vitals: HR, RR, temp, pulse, BP
  2. Venous or arterial blood gas with lactate
  3. POCUS
  4. CBC/chem, UA, coags, blood typing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What monitoring equipment do you want to use on patients with shock

A

ECG, BP, SPO2, serial pocus exams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how can you monitor tissue perfusion

A
  1. Body temp
  2. HR, RR
  3. MM and CRT
  4. MAP (70-100mmHg)
  5. Urine production
  6. Central venous pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the 4 quadrants for abdominal POCUS

A
  1. Diaphragmatic- hepatic
  2. Spleno-renal
  3. Bladder and colon
  4. Hepato-renal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what can you assess with abdominal POCUS

A
  1. Free fluid
  2. Free air
  3. Gall bladder wall edema
    4, gastrointestinal motility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are we looking at and what wrong

A

gallbladder wall edema- typically seen with anaphylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Abdominal POCUS- what do white arrows indicate

A

gas shadowing, could be due to perforated bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is indicated by E

A

free fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

when ultrasounding heart/ CVC in shock patient- what does a greater collapse of the CVC tell you

A

fluid responsive patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is normal lactate in dogs and cats

A

<2.5mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

shock leads to what type of hyperlactatemia

A

type A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

change in lactate or ___ is better predictor of survival than a single measurement

A

lactate clearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

lactate measurements can be used to guide resuscitative efforts in __

A

hypovolemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does high lactate indicate about oxygen delivery and uptake

A

inadequate delivery and uptake—> inadequate tissue perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how can you increase oxygen content when you see high lactate

A

RBC transfusion, oxygen supplementation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how can you increase o2 delivery when you see high lactate

A

fluid therapy, vasopressors, inotropes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do you measure cardiac output

A

pulmonary arterial catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what measurements can you obtain with pulmonary arterial catheter

A

central venous pressure, pulmonary arterial pressure, pulmonary capillary wedge pressure, cardiac output, mixed venous blood oxygen content

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the pros for pulmonary artery catether

A
  1. Determine fluid volume status
  2. Determine oxygen content of arterial and mixed venous blood
  3. Determine oxygen delivery, consumption and extraction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the cons of pulmonary artery catheter

A

arrhythmias, damage to valves, risk of hemorrhage, risk of pulmonary thromboembolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

if you want to measure mixed venous oxygen saturation must place a __

A

pulmonary artery catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what does the measurement of mixed venous oxygen saturation determine

A

difference between oxygen supply and demand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

if patients SvO2 is decreasing what does that mean

A

condition is deteriorating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what is normal SV02
70-75%
26
What do you need to measure central venous oxygen saturation
central venous catheter
27
what is normal ScVO2
65%-70%
28
what is the clinical use of oxygen saturation values
1. Maintain delivery of oxygen to peripheral tissues 2. ScvO2 can be useful prognostic indicator
29
what happens to CO, contractility and SVR with hypovolemic shock and what is therapy
CO- decreased Contractility- increased SVR: increased Tx: fluid resuscitation
30
what happens to CO, contractility, and SVR with obstructive shock and what is tx
CO- decreased Contractility- normal/increased SVR: increased Tx: relieve obstruction and fluid resuscitation
31
What is CO, contractility and SVR for cardiogenic shock and what is tx
CO- decreased Contractility- decreased SVR: increased Tx: positive inotrope
32
what is CO, contractility, and SVR for maldistributive shock and what is tx
CO- increased or decreased Contractility- increased or decreased SVR: decreased Tx: vasopressors
33
what type of shock do you not want to consider fluids
cardiogenic shock
34
which fluids has a similar composition to that of extracellular fluid
isotonic crystalloids
35
isotonic crystalloids allow for rapid, but ___expansion of ___ volume
short lived, intravascular
36
what is fluid bolus dose for isotonic crystalloids
10-20ml/kg IV over 15-30 minutes
37
How do you calculate shock dose for cats and dogs for isotonic crystalloids
dogs: 60-90ml/kg (kg)/4 Cats: 45-60ml/kg (kg)/4
38
how do you assess patients intravascular volume status
1. PE 2. Perfusion parameters 3. Pulmonary-lung US 4. Gallbladder edema
39
what is the rose principle of fluid prescription
give fluids and initial phase will make patient better followed by risk of hypovolemia
40
Do you need a smaller or large volume of hypertonic solution for fluid resuscitation and why
smaller, effective osmolarity that exceeds normal plasma
41
what are the pros of hypertonic saline
1. Small volume for septic shock, hemorrhagic shock, TBI 2. Anti-inflammatory 3. Decrease ICP
42
what are the cons of hypertonic saline
1. Can worsen interstitial volume depletion in dehydrated patients 2. Can cause hypernatremia and hyperchloremia 3. Neurologic signs if used in chronic hyponatremic patients
43
t or f: colloids do not readily cross diffusion barriers
true
44
colloids remain in vascular space leading to __
sustained intravascular expansion effect
45
what are the pros of synthetic colloids
1. Sustained retention of intravascular volume 2. Cost effective 3. Use din hypoalbuminemic patients
46
what are the cons of synthetic colloids
1. Coagulation disturbances 2. Acute kidney injury
47
what is dose for whole blood transfusion
20ml/kg
48
how do you calculate volume of whole blood to increase PCV
volume= 2x PCV rise desired X BW (kg)
49
what is dose for packed RBC transfusion
10-20ml/kg
50
what is dose for fresh frozen plasma transfusion
10-20ml/kg
51
when is albumin given to dogs
severe hypoalbuminemia <1g/dl
52
when raising BP with hypotensive resuscitation what do you want to raise systolic BP to as temporary solution until definitive hemostatic control
80-90mmHg
53
what is dehydration replacement calculation
patients % dehydrated X BW= dehydration volume L
54
what is maintenance fluid rate calculation
Kg X 30 +70=x X/24
55
what conditions is catecholamine therapy (pressor) used for
distributive shock, anaphylaxis, septic shock
56
what receptors do catecholamines act on
alpha and beta
57
what are the pros of catecholamine therapy
1. Increase HR 2. Increase vascular tone
58
what is definitive tx for anaphylaxis
epi
59
what are the cons of catecholamine therapy
1. Arrhythmias 2. Vasoconstriction of Splanchnic blood supply 3. Increased cardiac oxygen consumption
60
what are some examples of positive inotropes used for cardiogenic shock
1. Dobutamin- Beta1 agonist 2. Pimobendan: PDE III inhibitor and calcium sensitization
61
what are the pros of dobutamine
increased contractility and HR
62
what are the cons of positive inotropes
1. Arrhythmias 2. Dobutamine can cause seizures in cats at high doses
63
what is MOA of vasopressin
vasoconstrictor that acts on arterial smooth muscle V1 receptors
64
what types of shock is vasopressin used in
distributive and septic shock
65
what are the pros of vasopressin
increased vascular tone without any effect on HR and contractility, increase action of NE
66
what are the cons of vasopressin
increased water reabsorption by kidneys, caution with cardiac disease, expensive

SAMS 1 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions