24 & 25: Vascular Problems 2

Question 1

What changes will occur in CO and TPR with anaemia?

Answer 1

• CO increases

- TPR decreases

Question 2

What are the 6 Ps observed with compartments syndrome?

Answer 2

• Pain (on passive extension)
• Pallor
• Pulselessness
• Paraestheia (sensation)
• Paralysis
• Perishing cold

Question 3

What are the 2 aetiologies of pulmonary oedema?

Answer 3

• Cardiogenic

- non-cardiogenic

Question 4

How are the aetiologies of cardiogenic and non-cardiogenic pulmonary oedema different?

• Hydrostatic pressure
• Oedema

Answer 4

Cardiogenic - inc hydrostatic pressure, inc fluid filtration (protein poor)

Noncardiogenic- normal hydrostatic pressure, inc infiltrate of pro-inflammatory mediators, protein rich oedema

Question 5

Which test is a quick way of differentiating between cardiogenic and noncardiogenic pulmonary oedema?

Answer 5

BNP levels

Question 6

Why does haematocrit decrease after a few hours of haemorrhage?

Answer 6

Fluid is reabsorbed from the interstitium to try and increase blood volume (only happens after a couple of hours)

Question 7

What causes loss of vascular tone in circulatory shock?

Answer 7

• Inadequate perfusion of vessel walls (vasa vasorum)
• Depletion of NA in nerve terminals (impaired adrenergic neurotransmission)
• Perivascular accumulation of vasodilator metabolites and local release of histamine, serotonin, kinins, prostaglandins

Question 8

Changes in circulatory shock lead to the net transfer of fluid from the ____ to the ____, resulting in failure to maintain ____ despite replacement of the initial deficit.

Answer 8

• Vascular space to interstitial compartment

- Blood volume

Question 9

What is the rationale behind treatment for circulatory shock?

Answer 9

Maintain perfusion pressure until the effects of sustained ischaemia are reversed