Physiology and Treatment of Shock

Question 1

What is shock?

Answer 1

A state of inadequate perfusion, meaning normal organ function cannot be sustained.

Question 2

What are the 5 main types of shock?

Answer 2

Hypovolaemic
Cardiogenic
Obstructive
Distributive
Cytotoxic

Question 3

What is the most common cause of hypovolemic shock?

Answer 3

Trauma

Question 4

What is the most common cause of cardiogenic shock?

Answer 4

Myocardial infarction

Question 5

What are the clinical signs of cardiogenic shock?

Answer 5

Hypotension
Fatigue
Syncope
Pulmonary oedema
Raised JVP
Hepatic congestion

Question 6

What is inotropy?

Answer 6

A measure of the contractile state of the myocardium for any given preload.

Question 7

What are positive inotropes?

Answer 7

Drugs which can be given to increase stroke volume.

Question 8

What are 4 examples of positive inotropic drugs?

Answer 8

Dobutamine
Adrenaline
Dopamine
Milrinone

Question 9

If pharmacological treatment is insufficient in cardiogenic shock, what can be given?

Answer 9

Fit an intra-aortic balloon pump.

Question 10

What are the 3 subtypes of distributive shock?

Answer 10

Septic shock
Anaphylactic shock
Neurogenic shock

Question 11

What compensation occurs in early distributive shock?

Answer 11

Cardiac output increases, however as vasodilation continues, compensatory mechanisms become insufficient.

Question 12

What are the 2 shockable cardiac arrest arrhythmias?

Answer 12

Ventricular fibrillation (VF)
Pulseless ventricular tachycardia

Question 13

What are the 2 non-shockable cardiac arrhythmias?

Answer 13

Asystole

Pulseless electrical activity

Question 14

How does pulseless electrical activity present?

Answer 14

Will have cardiac output, but no pulse.

Question 15

Which of the cardiac arrest arrhythmias has the worst outcome?

Answer 15

Asystole