Physiology and Mx of Shock Flashcards
What is Shock?
Generalised Cellular Dysfunction due to the inadequate delivery or utilisation of Oxygen
A condition of inadequate perfusion to sustain normal organ function with resulting organ dysfunction and eventual death.
What do Cells need?
- Energy source (Glucose, Fat, Protein)
- Pump and Plumbing (Heart, Valves, Vessels, Fluid)
- Oxygen
- Engine room (mitochondria)
Shock is Classified by cause into:
- Hypovolaemic
- Cardiogenic
- Obstructive
- Distributive
- Cytotoxic
What is Hypovolaemic shock?
Shock occurring due to loss of circulating volume with resulting fall in CO.
What can cause Hypovolaemic shock?
Due to loss of blood in Haemorrhagic shock
Electrolyte rich fluid due to third space losses or due to severe dehydration.
Bleeding, Diarrhoea, Sweating
What causes Cardiogenic shock?
Occurs due to failure of the heart to function as an effective pump and may complicate acute MI, Myocarditis or Acute Valve pathology.
What is Obstructive Shock?
Shock occurring due to physical obstruction to the heart or great vessels which impairs cardiac filling.
What are common causes of Obstructive shock?
PE or Cardiac tamponade.
Tension Pneumothorax another cause.
How is Obstructive shock treated?
Treat the underlying cause e.g. Thrombolysis for PE, Thrombectomy (also PE),
Pericardiocentesis for cardiac tamponade.
Which types of shock does Distributive shock encompass?
- Septic
- Anaphylactic
- Neurogenic shock
What occurs in the Distributive shocks?
Uncontrolled vasodilation overcomes the compensatory mechanisms of increased CO
What causes Septic Shock?
Infection (of any kind)
What is the Tx of Septic shock?
Abx, Fluids, Vasopressors, SEPSIS6
What is Anaphylactic shock?
Gross vasodilation which is completely inappropriate in relation to the issue.
What happens in anaphylactic shock to bring about its effects?
Degranulation of Mast cells and Histamine Release.
