shock

Question 1

distributive shock includes…

Answer 1

septic, anaphylactic, and neurogenic

Question 2

vasodilatory/normovolemic shock

Answer 2

“distributive shock”
- loss in blood vessel tone leading to loss of vascular volume into the extravascular space

Question 3

allergy to blood products

Answer 3

whole blood is the highest and albumin is the lowest

Question 4

1st exposure to an allergen

Answer 4

Ige synthesis by B cells

Question 5

2nd exposure to an allergen

Answer 5

Ige modulated within 15 min

Question 6

Histamine

Answer 6

mediates allergic inflammatory response by binding to H1 on endothelial and smooth muscle cells to cause vasodilation and bronchoconstriction

Question 7

increase in vascular permeability

Answer 7

change in osmotic pressure causing fluid to shift out of circulation leading to edema

Question 8

bronchoconstriction

Answer 8

low pressure due to vasodilation which activates platelets releasing from mast cells

Question 9

anaphylactic shock

Answer 9

hypoperfusion of organs and fluid shift leading towards circulatory collapse

Question 10

anaphylaxis treatment

Answer 10

adrenergic agonist, glucocorticoids

Question 11

epinephrine and dexamethasone

Answer 11

treatment for anaphylaxis

Question 12

anaphylactic shock treatment

Answer 12

A- beta 2 agonist
B- oxygen
C- NS, IV adrenergics

Question 13

shock

Answer 13

hypoperfusion of organs leading to lack of nutrients and O2 to meet demands and can result in metabolic acidosis

Question 14

hypovolemic shock

Answer 14

low blood volume leading to decreased cardiac output due to trauma or severe dehydration
- 20% loss

Question 15

cardiogenic shock

Answer 15

low cardiac output due to ineffective pumping of heart; causes myocardial infarction
- will present as low SBP, hypoxia, cyanosis, high JVP

Question 16

obstructive shock

Answer 16

heart is not able to fill properly leading to an obstruction
- examples are pulmonary embolism or cardiac tamponade (heart does not stretch between contractions)

Question 17

hypovolemic shock treatment

Answer 17

-ADH to increase water presence
-NS or LR
-Albumin to increase proteins and expand plasma volume
-Whole blood

Question 18

lung injury (ARDS) due to hypovolemic shock

Answer 18

hypoperfusion causes inflammation leading to pulmonary edema causing membrane thickening which leads to low gas exchange
- will present as low O2 and tachypnea

Question 19

MODS

Answer 19

multiple organ dysfunction due to hypovolemic shock

Question 20

low cardiac output

Answer 20

causes high preload and afterload and low coronary artery perfusion

Question 21

right sided heart failure

Answer 21

liver congestion, GI congestion, weight gain, edema

Question 22

left sided heart failure

Answer 22

pulmonary issues, decreased cardiac output, impaired gas exchange, pulmonary edema, extreme fatigue

Question 23

adrenalin to increase cardiac output and HR, noradrenaline to maintain CPP, dopamine to decrease vascular resistance, and intra-aortic balloon pump to create suction effect to increase blood flow

Answer 23

cardiogenic shock treatment

Question 24

diuretics (spironolactone and lasix), direct acting vasodilators (nitroprusside, nitroglycerine ACE inhibitor, calcium channel antagonist), phosphodiesterase inhibitors (milrinone), beta blockers

Answer 24

HF treatment

Question 25

HF treatment

Answer 25

reduce volume
vasodilate
improve contractility

Question 26

intra-aortic balloon pump

Answer 26

creates suction effect in aorta to increase blood flow
- inflates during ventricular diastole and deflates right before ventricular systole

Question 27

tamponade treatment

Answer 27

pericardiocentesis

Question 28

pulmonary embolism treatment

Answer 28

anticoagulants and thrombolytics