14: Shock and MODS

Question 1

Anaphylactic Shock

Answer 1

Distributive shock state from severe allergic reaction

Acute systemic vasodilation and relative hypovolemia

Question 2

Cardiogenic Shock

Answer 2

Shock state resulting from impairment or failure of the myocardium

Question 3

Colloids

Answer 3

IV solutions with molecules to large to pass through capillary membranes

Question 4

Crystalloids

Answer 4

IV electrolyte solutions that move freely between intravascular and interstitial spaces

Question 5

Distributive Shock

Answer 5

Shock state from displacement of intravascular volume creating a relative hypovolemia and inadequate tissue perfusion

Question 6

Hypovolemic Shock

Answer 6

Shock state resulting from decreased intravascular volume due to fluid loss

Question 7

Multiple Organ Dysfunction Syndrome

Answer 7

Altered function of two or more organs

Question 8

Neurogenic Shock

Answer 8

Shock state from loss of sympathetic tone causing relative hypovolemia

Question 9

Sepsis

Answer 9

Organ dysfunction from dysregulated host response to infection

Question 10

Shock

Answer 10

Condition in which there is inadequate blood flow to tissues and cells

Question 11

Systemic Inflammatory Response Syndrome

Answer 11

Initiation of inflammatory response that is systemic vs local

Question 12

Components for Adequate Blood Flow

Answer 12

Effective cardiac pump
Adequate vasculature
Sufficient blood volume
*Think in time

Question 13

Cellular Energy Form

Answer 13

ATP
Made aerobically (More efficient from glu)
and anaerobically (Prod toxic lactic acid)

Question 14

Effects of Low O2

Answer 14

Cells must produce own energy
Acidotic Intracellular Environment (Metabolic Acidosis)
Cell swells
Influx of Na+/H20E
Efflux of K+
Mitochondrial damage
Hyperactive clotting factors lodge in microvasculature

Question 15

MAP

Answer 15

Cardiac Output x Peripheral Resistance

Question 16

Cardiac Output

Answer 16

From Stroke Volume and Heart Rate

Question 17

Stroke Volume

Answer 17

Volume of blood ejected from LV

~70mL

Question 18

MAP Parameters

Answer 18

> 65mmHg for cells to receive oxygen

Question 19

Respiratory Rate Increases

Answer 19

Rate increases to compensate for low O2
Removes CO2
Compensatory respiratory alkalosis

Question 20

Use of Sedation

Answer 20

Lower metabolic and oxygen demands

Question 21

Hypotension

Answer 21

BP <90 systolic

Question 22

Heart During Shock

Answer 22

Attempts to meet O2 requirements produces ischemia, leading to heart failure
Lack of blood = Dysrhythmias
>150bpm

Question 23

Lungs During Shocks

Answer 23

Rapid and shallow
Crackles
Decreased O2, increased CO2
Hypoperfused alveoli stop producing surfactant and collapse

Question 24

Renal During Shock

Answer 24

<65map = no glomerular filtration
AKI = Increase BUN / Cr
Urine output <30mL/hr

Question 25

Liver During Shock

Answer 25

Decreased blood flow = less metabolic and phagocytotic effects = increases in ammonia + lactic acid
Gluconeogensis and glycogenolysis are impaired
Infection?
Elevated bilirubin

Question 26

GI During Shock

Answer 26

Ischemia