Pathophysiology Of Shock

Question 1

Hypovolumic Shock
Cardiogenic shock
Obstructive shock
Distributive shock
Septicemic
Anaphylactic shock
Neurogenic shock

Answer 1

Low blood volume
Low cardiac output
Obstruction to blood flow to heart
Low peripheral resistance: pulling of blood doesnt allow blood to leave and tissue gets less blood
Endotoxic infection shock
Anaphylactic
Nerve damage

Question 2

Hypovolumic shock

Answer 2

Hemorrhage
Loss of plasma volume or interstitial fluid

Question 3

Compensated Initial stage hypovolemic

Answer 3

Low BV low CO it will reduce BP
Baroreceptors will go to increase contractility HR increase vasconstriction increase TPR

Low CO low LVEDP (reduced blood VR left side of the heart) high SVR

Cold pale clammy skin low GFR and renal excretion

Low blood low oxygen and that will stimulate the breathing center hyperventilation tachypnea

Question 4

Decompensated Progressive Stage (Stage 2)

Answer 4

Low O2 lactic acid vasoconstriction and vasodilation of different sides
Blood pooling of capillaries causing capillary leakage
Vital organ fail

Hypotension low volume cold pale clammy skin intense thirst rapid respiration restlessness low urine output

Question 5

Neural
Metabolic

Answer 5

No sympathetic reflex
Lactic acidosis anaerobic glycolysis
Class II losing 15 - 30%
Irrevesible >40% refractory

Question 6

Cardiogenic

Answer 6

low CO
MI
Arrhythmia - cardiogenic heart stuff!
Heart attack contractility low left ventricle after assisto blood will increase because you cant empty blood
Pulmonary circulation pressure will increase because of congestion
While hypovolemic shock is reduced

Question 7

Obstructive shock
Distributive shock

Answer 7

Obstructing cardiac outflow
Low VR in arterioles am

Question 8

Septic shock

Answer 8

Shock from infection IL 1 anf TNF alpha
There was an increase CO initially due to vasodilation causing increased VR
Decreased LVEDP is reduced due to neutrophil transmigration and pulmonary capillaries
Eary warm hyperdyamic
Late cold

Question 9

Neurogenic shock

Answer 9

Nerve damage imbalance between sym & para

Question 10

Anaphylactic shock

Answer 10

Histamine

Question 11

Septic Shock

Answer 11

Warm phase Hyperdynamic 6-72hrs and anaphylactics
High CO and contractility because the catecholamine keeps it that way low TPR
Cold phase: Hypodynamic
Below normal temperature
DIC low CO vasoconstriction

All questions on shock assume compensation

Question 12

Shock

Answer 12

All shocks has low blood pressure
Hypovolemic cardiogenic and PE or cardiac tamponade (ostructive) increased SVR and HR as compensation have decreased CO
Septic shock Anaphylactic Neurogenic SVR is low -> low BP from vasodilation (compensation cant correct it).
Anaphylacxis and warm septic are only 2 that have increased CO. Eas an

Question 13

Neurogenic shock

Answer 13

Causes bradycardia

Question 14

Pericardial Tamponade

Answer 14

Equalizes pressure to prevent collapse