Shock

Question 1

What is shock?

Answer 1

Systemic perfusion of organs

Question 2

What else do you get in shock besides hypoxia? (2)

Answer 2

Acidosis

Build up of toxins

Question 3

What effect do cytokines and secondary mediators have on myocardial contractility and cardiac output?

Answer 3

Diminish them

Question 4

Decreases in renal perfusion causes what?

Answer 4

Acute tubular necrosis

Anuria

Question 5

Acute respiratory distress syndrome is caused by what?

Answer 5

Inflammatory mediators

Question 6

Adrenal dysfunction causes what? (2)

Answer 6

Metabolic problems

Waterhouse-Fredrichensen syndrome

Question 7

Insulin resistance caused by what?

Answer 7

Impaired surface expression of GLUT-4 glucose transporter

Question 8

Lactic acidosis causes what? (2)

Answer 8

Vascular stasis

Cellular hypoxia and decreased oxidative phosphorylation

Question 9

Hypo-perfusion is synonymous with what?

Answer 9

Hypotension

Question 10

Formula for Blood pressure?

Answer 10

BP = CO x PR

Question 11

Inflammatory/Anaphylactic problems affect which part of the equation?

Answer 11

PR

Question 12

Neurogenic (spinal) affects which part of the equation?

Answer 12

CO and PR

Question 13

Heart Failure (cardiogenic)/Hypovolemia affect which part of the equation?

Answer 13

CO

Question 14

Cardiogenic causes? (4)

Answer 14

Ventrilcular fibrillation
Heart Failure
Cardiac Tamponade
Saddle pulmonary embolus

Question 15

Hypovolemic problems? (3)

Answer 15

Hemorrhage
Dehydration
Burns

Question 16

Volume loss stage progression?

Answer 16

Stage 1: Less than 15%
Stage 2: 15-30%
Stage 3: 30-40%
Stage 4: More than 40%

Question 17

Heart rate stage progression?

Answer 17

Stage 1: Not listed
Stage 2: More than 100
Stage 3: More than 120
Stage 4: More than 140

Question 18

Renal output stage progression?

Answer 18

Stage 1: Normal
Stage 2: 20-30 ml/hr
Stage 3: 20ml/hr
Stage 4: Negligible

Question 19

What happens to blood pressure as volume is lost?

Answer 19

It decreases

Question 20

Sepsis implies what?

Answer 20

Overwhelming systemic inflammation from bacteremia

Question 21

Most common cause of Sepsis?

Answer 21

E.coli

Question 22

In septic shock what is the endotoxin?

Answer 22

Lipopolysaccharide

Question 23

What cause toxic shock sepsis?

Answer 23

T-cell super antigen

Question 24

Innate response of septic shock? (5)

Answer 24

Recognition of microbial factors
Complement activation
Toll-like receptors
Activation of coagulation factors
Release of inflammatory mediators