Surgery - Shock

Question 1

Phase of shock where there are VASOCONSTRICTION, FLUID SHIFT TO ECF, and SALT AND H2O CONSERVATION

Compensated
Decompensated
Irreversible

Answer 1

Compensated

Question 2

PHASE OF SHOCK with ongoing tissue injury and continued hypoperfusion; can be reversed with proper resuscitation

Compensated
Decompensated
Irreversible

Answer 2

Decompensated

Question 3

PHASE OF SHOCK with persistent hypoperfusion and fluid resuscitation; vasopressors fail to maintain adequate BP

Compensated
Decompensated
Irreversible

Answer 3

Irreversible

Question 4

TYPE OF SHOCK: Cause is significant and sudden blood and fluid loss

Hemorrhagic
Cardiogenic
Septic
Neurogenic
Obstructive

Answer 4

Hemorrhagic

Question 5

TYPE OF SHOCK: Most common cause of shock in the surgical or trauma patient

Hemorrhagic
Cardiogenic
Septic
Neurogenic
Obstructive

Answer 5

Hemorrhagic

Question 6

TYPE OF SHOCK: Signs are agitation, pallor, cold clammy extremities, tachycardia, weak or absent peripheral pulse

Hemorrhagic
Cardiogenic
Septic
Neurogenic
Obstructive

Answer 6

Hemorrhagic

Question 7

At what percentage of blood loss will the signs for HEMORRHAGIC SHOCK be apparent?

Answer 7

25-30% blood loss

Question 8

Treatment for HEMORRHAGIC SHOCK

Answer 8

Secure airway
Control bleeding
IV volume resuscitation

Question 9

TYPE OF HEMORRHAGIC SHOCK: less than or equal to 100mL blood loss

Compensated
Mild
Moderate
Severe

Answer 9

Compensated

Question 10

TYPE OF HEMORRHAGIC SHOCK: 1000-1500mL blood loss

Compensated
Mild
Moderate
Severe

Answer 10

Mild

Question 11

TYPE OF HEMORRHAGIC SHOCK: 1500-2000mL blood loss

Compensated
Mild
Moderate
Severe

Answer 11

Moderate

Question 12

TYPE OF HEMORRHAGIC SHOCK: > 2000

Compensated
Mild
Moderate
Severe

Answer 12

Severe

Question 13

TYPE OF HEMORRHAGIC SHOCK: < 100 heart rate

Compensated
Mild
Moderate
Severe

Answer 13

Compensated

Question 14

TYPE OF HEMORRHAGIC SHOCK: > 100 heart rate

Compensated
Mild
Moderate
Severe

Answer 14

Mild

Question 15

TYPE OF HEMORRHAGIC SHOCK: > 120 heart rate

Compensated
Mild
Moderate
Severe

Answer 15

Moderate

Question 16

TYPE OF HEMORRHAGIC SHOCK: > 140 heart rate

Compensated
Mild
Moderate
Severe

Answer 16

Severe

Question 17

TYPE OF HEMORRHAGIC SHOCK: orthostatic changes in BP

Compensated
Mild
Moderate
Severe

Answer 17

Mild

Question 18

TYPE OF HEMORRHAGIC SHOCK: marked full BP

Compensated
Mild
Moderate
Severe

Answer 18

Moderate

Question 19

TYPE OF HEMORRHAGIC SHOCK: Profound full bp

Compensated
Mild
Moderate
Severe

Answer 19

Severe

Question 20

TYPE OF HEMORRHAGIC SHOCK: moderate tachypnea

Compensated
Mild
Moderate
Severe

Answer 20

Moderate

Question 21

TYPE OF HEMORRHAGIC SHOCK: marked tachypnea

Compensated
Mild
Moderate
Severe

Answer 21

Severe

Question 22

TYPE OF HEMORRHAGIC SHOCK: anuria

Compensated
Mild
Moderate
Severe

Answer 22

Severe

Question 23

TYPE OF HEMORRHAGIC SHOCK: Anxious

Compensated
Mild
Moderate
Severe

Answer 23

Mild

Question 24

TYPE OF HEMORRHAGIC SHOCK: Confused

Compensated
Mild
Moderate
Severe

Answer 24

Moderate

Question 25

TYPE OF HEMORRHAGIC SHOCK: lethargic Compensated Mild Moderate Severe

Answer 25

Severe

Question 26

TYPE OF SHOCK: cause is extensive myocardial infarction ``` Hemorrhagic Cardiogenic Septic Neurogenic Obstructive ```

Answer 26

Cardiogenic

Question 27

Criteria for cardiogenic shock

Answer 27

Sustained hypotension Reduced cardiac index Elevated pulmonary artery wedge pressure

Question 28

TYPE OF SHOCK: signs are hypotension, cool mottled skin, depressed mental status, tachycardia, diminished pulse ``` Hemorrhagic Cardiogenic Septic Neurogenic Obstructive ```

Answer 28

Cardiogenic

Question 29

Cardiogenic shock treatment: fxn of dobutamine

Answer 29

Stimulate beta1 receptors and increase cardiac output

Question 30

Cardiogenic shock treatment: fxn of dopamine

Answer 30

Stimulate alpha1 receptor -> vasoconstriction

Question 31

Cardiogenic shock treatment used for patients unresponsive to other treatments

Answer 31

Phosphodiesterase inhibitors Amrinone and Milrinone

Question 32

TYPE OF SHOCK: final common pathway for profound and prolonged shock of any etiology ``` Hemorrhagic Cardiogenic Septic Neurogenic Obstructive ```

Answer 32

Septic

Question 33

TYPE OF SHOCK: failure of vascular smooth muscle to constrict appropriately ``` Hemorrhagic Cardiogenic Septic Neurogenic Obstructive ```

Answer 33

Septic

Question 34

Most likely cause of sepsis in neonates

Answer 34

Group B strep E. coli bearing a pathogenic K1 capsule Klebsiella spp Enterobacter spp

Question 35

TYPE OF SHOCK: Signs are enhanced cardiac output, peripheral vasodilation, fever, hyperglycemia, tachycardia, confusion, malaise, oliguria, hypotension ``` Hemorrhagic Cardiogenic Septic Neurogenic Obstructive ```

Answer 35

Septic

Question 36

Systemic inflammatory response to infection

Answer 36

Sepsis

Question 37

Sepsis with 1 or more dysfunctional organ system

Answer 37

Severe sepsis

Question 38

TYPE OF SHOCK: diminished tissue perfusion as a result of loss of vasomotor tone of peripheral arterial beds ``` Hemorrhagic Cardiogenic Septic Neurogenic Obstructive ```

Answer 38

Neurogenic

Question 39

Neurogenic shock can be secondary to spinal cord injury from vertebral body fracture of the low thoracic and sacral region. True or false?

Answer 39

False Fracture should be of the CERVICAL OR HIGH THORACIC

Question 40

TYPE OF SHOCK: Signs are bradycardia, hypotension, cardiac dysrhythmia, decreased CO, decreased peripheral vascular resistance, warm extremities, motor and sensory deficit ``` Hemorrhagic Cardiogenic Septic Neurogenic Obstructive ```

Answer 40

Neurogenic

Question 41

TYPE OF SHOCK: mechanical obstruction of venous return ``` Hemorrhagic Cardiogenic Septic Neurogenic Obstructive ```

Answer 41

Obstructive

Question 42

TYPE OF SHOCK: most commonly due to presence of tension pneumothorax ``` Hemorrhagic Cardiogenic Septic Neurogenic Obstructive ```

Answer 42

Obstructive

Question 43

TYPE OF SHOCK: signs are respiratory distress, hypotension, diminished breath sounds, hyperresonance to percussion, jugular vein distention ``` Hemorrhagic Cardiogenic Septic Neurogenic Obstructive ```

Answer 43

Obstructive

Question 44

Treatment for obstructive shock: thoractomy should be inserted at 5th ICS AAL. True or false?

Answer 44

False 4th ICS AAL