4.-Fisiopato shock

Question 1

estado final de todos los shock?

Answer 1

desbalance entre demanda y aporte de O2 resultando en falla multiorganica

Question 2

porque cambio la clasificacion?

Answer 2

para estandarizar su manejo

Question 3

cuales son las 4 categorias?

Answer 3

hipovolemico
distributivo
cardiogenico
obstructivo

Question 4

con que sistema se relaciona shock hipovolemico?

Answer 4

con la sangre

Question 5

con que sistema se relaciona distributivo?

Answer 5

con el sistema vascular

Question 6

con que sistema se relaciona obstructivo?

Answer 6

con el sistema circulatorio

Question 7

cual es la defincion del shock hipovolemico?

Answer 7

inadecuada perfusion de organos causada por perdida de volumen intravascular

Question 8

en que resulta la perdida de volumen en el shock hipovolemico?

Answer 8

caida de precarga, y reduccion de macro y microhemodinamia con consecuencias para el metabolismo del tejido y desencadena reacion inflamatoria

Question 9

causas de shock hemorragico

Answer 9

acute
bleeding from an isolated injury to a large blood vessel,
gastrointestinal bleeding, nontraumatic vascular
rupture (e.g., aortic aneurysm), obstetric hemorrhage
(e.g., uterine atony), and hemorrhage in the region of
the ear, nose, and throat (vascular erosion).

Question 10

ejemplo de shock hemorragico traumatico

Answer 10

politrauma

Question 11

importancia de lesion de tejido blando?

Answer 11

The soft tissue injury
leads to postacute inflammation, . At the microcirculatory level, leukocyte–
endothelium interactions (5) and destruction of
endothelial membrane-
cause microvascular dysfunction
with capillary leak syndrome.

At the intracellular
level a metabolic imbalance arises (6) with possible
mitochondrial damage (7) and a negative influence on
the vasomotor system (8).

Question 12

causas de shock hipovoemico?

Answer 12

It can be caused by hyperthermia,
persistent vomiting and diarrhea (e.g., cholera),
or uncompensated renal losses (e.g., diabetes insipidus,
hyperosmolar diabetic coma). Sequestration of
large quantities of fluid in the abdomen, e.g., in ileus
or liver cirrhosis, also leads to a reduction of
circulating plasma volume

Question 13

causas de shock hipovolemico traumatico?

Answer 13

traumatic hypovolemic shock are
large surface burns, chemical burns, and deep skin
lesions.

Question 14

importancia del trauma en shock hipovolemico?

Answer 14

activates the coagulation
cascade and the immune system, potentiating the
impairment of the macro- and microcirculation. The
inflammatory reaction results in damage to the endothelium,
increases capillary leak syndrome, and
causes severe coagulopathy

Question 15

manejo de shock hipovolemico

Answer 15

reanimacion con fluidos
controlar sangrado
intubar 
traslado a centor de trauma
qx de control de daños
pam por metas

Question 16

si embarazada sangrando?

Answer 16

tranexamico 1 a 2 gr

Question 17

si sangrado por herida de bala o arma blanca o aneurisma roto?

Answer 17

hipotension permisiva (PAS 70 a 80)

Question 18

si pcte quemado?

Answer 18

usar formula de brooks

Question 19

definicion de shock distributivo?

Answer 19

a state of relative hypovolemia resulting
from pathological redistribution of the absolute
intravascular volume and is the most frequent form of
shock

Question 20

causas de shock distributivo?

Answer 20

either a loss of regulation
of vascular tone, with volume being shifted within the
vascular system, and/or disordered permeability of the
vascular system with shifting of intravascular volume
into the interstitium.

Question 21

definicion de shock sepotico?

Answer 21

a dysregulated response by the body to an infection

resulting in life-threatening organ dysfunctions.

Question 22

fisiopato del shock septico?

Answer 22

endothelial
dysfunction, which leads to dysregulation of vascular
tone resulting in vasodilation, impaired distribution,
and volume shifting in the macro- and microcirculation,
and to a rise in vascular permeability

Question 23

caracteristicas de shock toxico

Answer 23

is characterized by fever, severe hypotension,
and skin rash as the main symptoms. It is usually
triggered by toxins from certain staphylococci. The

Question 24

incidencia y mortalidad de shock toxico

Answer 24

incidence is 0.5 / 100 000, and mortality is between

2% and 11%

Question 25

caracteristicas de shock anafilactico?

Answer 25

is characterized by massive
histamine-mediated vasodilation and maldistribution
with a shift of fluid from the intravascular to the
extravascular space.

Question 26

patogenesis de shock anafilactico?

Answer 26

acute systemic reaction usually
mediated by IgE-dependent hypersensitivity reactions.
central role is played by mast cells and the
histamine they release

Question 27

incidencia y mortalidad anafilaxia?

Answer 27

anaphylactic reactions is 50 per 100 000 / year
Lifetime prevalence is reported at 0.5% to 2% and
mortality at 2% to 20%.

Question 28

trigger de anafilaxia mas comun en niños?

Answer 28

comida

Question 29

trigger mas comun en adultos?

Answer 29

picadura de insecto

Question 30

definicion shock neurogenico?

Answer 30

a state of imbalance between
sympathetic and parasympathetic regulation of cardiac
action and vascular smooth muscle

Question 31

mecanismo fisiopatologicos shock neurogenico?

Answer 31

Direct injury to the centers for circulatory regulation
due to compression (brainstem trauma),
ischemia (e.g., basilar artery thrombosis), or the
influence of drugs
● Altered afferents to the circulatory center in the
medulla oblongata due to fear, stress, or pain or
dysregulated vagal reflexes
—Interruption of the descending connection from the
bulbar regulatory centers to the spinal cord,
especially in patients who have sustained trauma
above the middle of the thoracic spine (paraplegia).

Question 32

% de lesiones de ME que hacen shock neurogenico

Answer 32

15-20%

Question 33

causas de shock neurogenico?

Answer 33

cerebral ischemia,
subarachnoid hemorrhage, meningitis, or, more
rarely, during or after epileptic seizures, rapid onset of
Guillain–Barré syndrome, pandysautonomia, or
cerebral herniatio

Question 34

mortalidad shock neurogenico

Answer 34

20%