Module 2 Flashcards
(105 cards)
Aka Thrombin Sink. This forms a complex with Fibrin -> no cleavage of fibrinogen. This also activates Protein C which inhibits Factors V and VIII.
Thrombomodulin
Aka Christmas Disease or Factor IX Deficiency. The severity depends on levels of Factor VIII and IX
Hemophilia B
Aka Factor VIII Deficiency. This is the most common CONGENITAL bleeding d/o. Symptoms include: easy bruising, mucosal bleeding, menorrhagia (in women)
VonWillebrand Disease
Secondary hemostasis starts with the exposure of what factor? What is its end result?
Factor III/ Tissue Factor
Secondary hemostasis ends with consolidation of the platelet plug by Factor XIII
What is the integral role of platelets after vascular injury?
Formation of hemostatic plug. It also contributes to Thrombin formation.
What are the mechanisms of maintaining adequate preload?
Venoconstriction
Inc sympathetic tone = dec splanchic bf
RAAS
Coordinated Atrial Activity & Tachycardia
What is the most common organism isolated in Septic Shock?
62% Gram Negative: PSEUDOMONAS & E. COLI
47% Gram Positive: Staphylococcus aureus
19% Fungi: Candida
What are the signs and symptoms of patients with Acute Blood Loss?
Agitation Cool & clammy extremities Tachycardia Weak/absent peripheral pulse 25-30% + physiologic compensation
How much blood loss would be allowed to maintain normal bp & hr?
15% ~700-750mL
Patient has the following ssx:
600mL blood loss
85 bpm
120/80 bp
What class of Hypovolemic Shock is this?
Class I
Patient presented with 1800mL blood loss, 140bpm, 90/60 bp and is confused. What class of hypovolemic shock is this patient experiencing?
Class III
Patient presents with 800mL blood loss, 110bpm, and bp was 120/80 while supine and 90/65 when standing. This patient is experiencing what class of hypovolemic shock?
Class II
What is the role of Goal-oriented therapy for Septic Shock?
This is done during the first 6 hrsin the hospital. This aims to: Inc venous o2 saturation Dec lactate lvls Dec base deficit Inc pH Dec 28-day mortality rate
This is the most common type of shock; loss of circulating blood volume
Hypovolemic Shock
Type of shock: dec resistance w/in capacitance vessels
Vasodilatory/septic shock
Type of shock: failure of the heart as a pump
Cardiogenic shock
Form of vasogenic shock; spinal cord injury/anesthesia= vasodilation due to acute loss of sympathetic tone
Neurogenic Shock
Type of Shock: involves soft tissue + bone injury -> activation of inflammatory cells & release of circulating factors -> modulation of immune response.
The effects of tissue injury are combined with effects of hemorrhage.
Traumatic Shock
Type of Shock: form of cardiogenic shock; from mechanical impediment to circulation leading to decreased cardiac output
Obstructive Shock
HR
Class I
RR 30-40; 1500cc blood loss
Class III
Anxious with orthostatic hypotension
Class II
If juan is 60kg sustaining a stab wound with class III shock, how much is the blood loss?
30-40% or 1500-2000mL yan ang textbook definition ng class III hypovolemic shock. But based on man's wait which is 60kg... 60kg x 0.6 =36 kg 36x 1/3= 12kg 12 kg x 1/3 =4L blood vol
4L x 0.3 =1.2L
4L x 0.4 = 1.6 L
So range is 1.2-1.6L
Pedro is in shock with blood loss of 1500mL, what is the expected HR?
> 120bpm