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CVS > 5-Shock > Flashcards

5-Shock Flashcards

1
Q

Define shock

A

An acute condition of inadequate blood flow throughout the body

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2
Q

What is the formula for mean arterial pressure, with regard to diastolic and pulse pressure?

A

Mean arterial BP = Diastolic pressure X 1/3 pulse pressure

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3
Q

Define cardiogenic shock

A

Sudden failure of the heart to pump sufficient volume of blood

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4
Q

What are the causes of cardiogenic shock?

A

Damage to the left ventricle after an MI
Acute worsening of heart failure
Serious arrhythmias

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5
Q

Describe the events of cardiogenic shock

A

The heart fills but doesn’t pump effectively
Drop in arterial blood pressure
Poor tissue perfusion
Poor coronary perfusion exacerbates problem, poor kidney perfusion reduces urine production (oliguria)

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6
Q

What happens to central venous pressure in cardiogenic shock?

A

CVP is normal or raised

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7
Q

Define mechanical shock

A

Failure of the heart to fill due to a physical obstruction

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8
Q

What causes mechanical shock?

A

Pulmonary embolism

Cardiac tamponade

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9
Q

What side of the heart does mechanical shock due to cardiac tamponade affect?

A

Both

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10
Q

What effect does mechanical shock have on central venous pressure?

A

CVP is high

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11
Q

What effect does mechanical shock have on arterial blood pressure?

A

Low arterial BP

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12
Q

Describe how a pulmonary embolism can cause mechanical shock

A

Part of a DVT breaks off, travels through venous system
Pumped out of heart via pulmonary artery till it reaches the lungs, causing partial blockage
Pulmonary artery pressure increases
Right ventricle cannot empty
Central venous pressure high
Decreased return of blood to the left heart
Limited filling and low pressure in left heart
Arterial BP low
SHOCK!

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13
Q

Define hypovolaemic shock

A

Heart failure due to acute loss of blood volume

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14
Q

What causes hypovolaemic shock?

A

Haemorrhage
Severe burns
Severe diarrhoea/vomiting/loss of Na

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15
Q

What are the signs of hypovolaemic shock?

A

Tachycardia
Weak pulse
Pale
Cold and clammy extremities

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16
Q

What happens to central venous pressure in hypovolaemic shock?

A

CVP decreases

17
Q

What happens to arterial pressure in hypovolaemic shock?

A

Arterial pressure decreases

18
Q

What happens to cardiac output in hypovolaemic shock and why?

A

Cardiac output decreases due to starlings law, heart fibres are stretched less before contraction so do not contract as hard

19
Q

Describe how the body compensates for hypovolaemic shock

A 
Increased sympathetic stimulation 
Tachycardia 
Increased force of contraction
Peripheral vasoconstriction 
Venoconstriction 
Movement of fluid into capillaries as increased TPR reduces capillary hydrostatic pressure
20
Q

What are the dangers of decompensation in hypovolaemic shock and why does it occur?

A

Occurs as compensatory vasoconstriction causes tissue damage due to hypoxia, so vasodilators released.
Decreases TPR and BP falls dramatically, failure to perfuse organs

21
Q

What are they body’s long term responses to hypovolaemic shock?

A

Activation of RAAS and ADH

22
Q

Define distributive shock

A

Blood volume remains constant but circulating volume increases due to decreased TPR

23
Q

Define toxic/septic shock

A

Persisting hypotension requiring treatment to maintain blood pressure despite fluid resuscitation

24
Q

Describe the series of events that lead to septic shock

A

Endotoxins released by circulating bacteria
Excessive inflammatory response and profound vasodilation
Dramatic fall in TPR
Fall in arterial pressure
Capillaries become leaky due to reduced blood volume
Increased coagulation and vital organ hypoperfusion

25
Q

What effects does septic shock have on arterial pressure?

A

Arterial BP reduced

26
Q

What is the body’s response to septic shock?

A

Increased sympathetic output- vasoconstrictor effects overridden by mediators of vasodilation
Increased heart rate
Increased stroke volume

27
Q

Define anaphylactic shock

A

A severe allergic reaction resulting in poor perfusion to organs

28
Q

Describe the events that lead to anaphylactic shock

A

Histamine released from mast cells
Vasodilatory effect
Fall in TPR
Dramatic drop in arterial pressure
Increased sympathetic response, but increased cardiac output can’t compensate for the vasodilation
Impaired organ perfusion, bronchoconstriction and laryngeal oedema causing difficultly breathing

29
Q

What are the signs of anaphylactic shock?

A

Collapse
Difficulty breathing
Rapid heart rate
Warm red extremities

30
Q

How do you treat anaphylactic shock and why does it work?

A

Treat with adrenaline

Causes vasoconstriction via actions at a1 adrenoreceptors

CVS (10 decks)

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