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PATHOLOGY > SHOCK > Flashcards

SHOCK Flashcards

1
Q

DEFINE SHOCK

A

A STATE OF TISSUE HYPOPERFUSION AND CELLULAR HYPOXIA RESULTING IN REDUCE CO AND REDUCE ECV.

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2
Q

TYPES OF SHOCK

A
  1. HYPOVOLAEMIC SHOCK
  2. CARDIOGENIC SHOCK
  3. ANAPHYLACTIC SHOCK
  4. SEPTIC SHOCK
  5. NEUROGENIC SHOCK
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3
Q

HYPOVOLAEMIC SHOCK

A

INADEQUATE BLOOD OR PLASMA VOLUME

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4
Q

CAUSE OF HYPOVOLAEMIC SHOCK

A

HAEMORRHAGIC
- POST PARTUM BLEEDING
- BLEEDING OESOPHAGEAL VARICES
- TRAUMA
- ANEURYSM RUPTURE
- MASSIVE HAEMOPTYSIS

NON HAEMORRHAGIC
- SEVERE VOMITING/ DIARRHEA
- BURN
- INCREASED URINE OUTPUT SUCH AS IN DKA, HHS
- ACUTE PANCREATITIS
- DENGUE SHOCK SYNDROME

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5
Q

MECHANISM OF HYPOVOLAEMIC SHOCK

A

REDUCED ECV D/T BLOOD / PLASMA LOSS -> REDUCE VR -> REDUCE CO -> SYSTEMIC TISSUE HYPOPERFUSION -> WIDESPREAD OF CELLULAR HYPOXIA -> IMPAIRED IN THE CELLULAR METABOLISM AND CELL DEATH -> IRREVERSIBLE CELL INJURY -> MULTIPLE ORGAN DYSFUNCTION

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6
Q

CAUSE OF CARDIOGENIC SHOCK

A
  • MYOCARDIAL INFARCTION
  • VENT. RUPTURE
  • MYOCARDIAL CONTUSION
  • ARRHYTHMIA
  • CARDIOMYOPATHY
  • VALVULAR DEFECTS
  • TENSION PNEUMOTHORAX
  • CARDIAC TAMPONADE
  • LARGE PE
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7
Q

MECHANISM OF CARDIOGENIC SHOCK

A

CARDIAC PUMP FAILURE D/T
1. INTRINSIC DAMAGE
2. EXTRINSIC COMPRESSION
3. OUTFLOW OBSTRUCTION

-> REDUCE CO -> SYSTEMIC TISSUE HYPOPERFUSION -> WIDESPREAD OF CELLULAR HYPOXIA -> IMPAIRED IN THE CELLULAR METABOLISM AND CELL DEATH -> IRREVERSIBLE CELL INJURY -> MULTIPLE ORGAN DYSFUNCTION

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8
Q

DEFINE SEPTIC SHOCK

A

MICROBIAL INFECTION A/W SYSTEMIC HOST INFLAMMATORY RESPONSE

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9
Q

MECHANISM OF SEPTIC SHOCK

A

REFER TO NOTES

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10
Q

DEFINE ANAPHYLACTIC SHOCK

A

IG-E MEDIATED HYPERSENSITIVITY REACTION TOWARDS ALLERGEN

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11
Q

MECHANISM OF ANAPHYLACTIC SHOCK

A

REFER NOTES

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12
Q

DEFINE NEUROGENIC SHOCK

A

SPINAL CORD INJURY RESULTING IN AUTONOMIC DYSFUNCTION

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13
Q

EXAMPLE CAUSES OF NEUROGENIC SHOCK

A

MVA
SPORTS INJURY
FALLS
ACTS OF VIOLENCE
OCCUPATIONAL ACCIDENT
NATURAL DISASTER

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14
Q

MECHANISM OF NEUROGENIC SHOCK

A

REFER NOTES

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15
Q

STATE THE STAGE OF SHOCK

A
  1. NON PROGRESSIVE (COMPENSATED) STAGE
  2. PROGRESSIVE (DECOMPENSATED) STAGE
  3. IRREVERSIBLE STAGE
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16
Q

BRIEFLY DESC COMPENSATED STAGE

A
  1. NEURAL REGULATION
    - REDUCE CO AND PERFUSSION PRESSURE
    - DETECTED BY THE BARORECEPTOR
    - ACTIVATION OF THE SYMPATHETIC STIMULATION
    - INCREASE IN THE MYOCARDIAL CONTRACTILITY
    - INCREASE IN THE HR
    - VASOCONSTRICTION SUPPLYING THE NON VITAL ORGAN -> SHUNTING OF BLOOD TO THE VITAL ORGAN
    - INCREASE RESP. RATE
  2. HORMONAL REGULATION
    - RAAS PATHWAY ACTIVATION
    - ADH AND ALDOSTERONE SECRETION
    - NA+ REABSORPTION
    - WATER RETENTION
    - VASOCONSTRICTION
  3. BIOCHEMICAL REGULATION
    - STIMULATING THE RESP CENTRE
    - D/T CELLULAR HYPOXIA -> LACTIC ACIDOSIS
    - INCREASE IN THE H+ PRODUCTION
    - REDUCE THE PH
    - COMPENSATE: HYPERVENTILATION
17
Q

BRIEFLY DESC PROGRESSIVE STAGE

A

PERSISTENT SHOCK -> COMPENSATORY MECHANISM OVERWHELMED -> OXYGEN DEFICIT INCREASE -> ANAEROBIC GLYCOLYSIS -> LACTIC ACID PRODUCTION INCREASE -> INCREASE H+ -> METABOLIC ACIDOSIS AND FALL OF PH -> BLUNT THE VASOMOTOR RESPONSE -> PERIPHERAL VASODILATION AND POOLING OF BLOOD -> TISSUE HYPOPERF. -> CELLULAR HYPOXIA

VITAL ORGAN START TO FAIL:
- REDUCE CO
- RESP DISTRESS
- OLIGURIA
- ALTERED MENTAL STATUS

18
Q

BRIEFLY DESC IRREVERSIBLE SHOCK

A

WIDESPREAD CELLULAR HYPOXIA -> ABNORMALITIES IN METABOLIC FUNCTION AND CELL DEATH -> IRREVERSIBLE INJURY D/T:
- LEAKAGE OF LYSOSOMAL ENZYME
- WORSENING OF THE MYOCARDIAL CONTRACTILE F(X) D/T INCREASE NO SYNTHESIS
- ISCHAEMIC BOWEL -> INTESTINAL FLORA TO ENTER THE CIRCULATION -> SUPERIMPOSED SEPTIC SHOCK
- ISCHAEMIC KIDNEY -> RENAL FAILURE

BY TIME, IT CAN LEAD TO DEATH

19
Q

5 COMPLICATIONS OF SHOCK

A

BRAIN: COMA
HEART: MYOCARDIAL INFARCTION
KIDNEY: ATI
RESP: RESP FAILURE/ ARDS
GI: BOWEL INFARCTION

20
Q

LAB FINDINGS OF DIC

A
  • THROMBOCYTOPENIA (LOW PLATELET)
  • PROLONGED PT/APTT (CLOTTING FACTOR REDUCE)
  • LOW FIBRINOGEN
  • ELEVATED FIBRIN DEGRADATION PRODUCT SUCH AS D- DIMER
21
Q

BAD PROGNOSIS

A

SEPTIC
CARDIOVASCULAR

22
Q

SHORTER DURATION OF SHOCK HAVE __ OUTCOME

A

BETTER

PATHOLOGY (13 decks)

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