107 - Hypovolaemia

Question 1

What is hypovolaemic shock?

Answer 1

Loss in 20% of circulating blood volume

Question 2

What are the signs of shock?

Answer 2

Collapse
Reduced conscious level
Rapid breathing
Tachycardia
Hypotension
Poor peripheral perfusion
Low urine flow
Increased blood lactate levels

Question 3

What is the ‘tennis score’ estimation of blood loss?

Answer 3

0-15% lost - thirst
15-30% lost - tachycardia
30-40% - hypotension
40% + - game over

Question 4

What is a darrow-yannet diagram?

Answer 4

Graph that shows ICF and ECF, its osmolarity and volume

Question 5

How is fluid distributed throughout the body?

Answer 5

20% of bodyweight = extracellular fluid
40% of bodyweight = intracellular fluid
60% of body weight = total body water volume

Question 6

What does it mean if something is isomotic?

Answer 6

It is the same osmolality as plasma

Question 7

Which fluid compartment has low sodium and high potassium?

Answer 7

ICF - the others have the opposite

Question 8

What is Extracellular fluid subdivided into?

Answer 8

interstitial fluid (11l)
plasma (3l)

Question 9

How is osmoregulation controlled?

Answer 9

Hypothalamic osmoregulatores detect change, and stimulate ADH and thrust - so water excretion and intake is effected.

Question 10

How is volume of fluid regulation controlled?

Answer 10

Less well understood - the effective circulating vol is sensed by carotid sinus, afferent arterioles and atria.

This stimulates:

• renin-angiotensin-aldosterone system
• sympathetic NS
• Atrial natriuretic peptide
• Pressure naturisis
• ADH production
• affects the body’s Na concentration

Question 11

what is starling’s hypothesis?

Answer 11

The flow of fluids across capillary walls depends on the balance between hydrostatic and oncotic forces.

Question 12

What are the 3 pathophysiological stages/types of shock?

Answer 12

Nonprogressive Shock
Pregressive shock
Irreversible phase

Question 13

What is non progressive shock?

Answer 13

Recovers without treatment

Question 14

What is progressive shock?

Answer 14

Can recover but only with rapid treatment - causes damage such as cardiac depression, increased vascular permeability, sickle cell syndrome

Question 15

What is irreversible shock?

Answer 15

They may temporarily recover but will still die
Have SIRS - systemic inflammatory response syndrome
and DIC : disseminated intravascular coagulation