8- Circulatory Shock

Question 1

BP =

Answer 1

SVR x CO

Question 2

CO =

Answer 2

HR x SV

Question 3

SV =

Answer 3

EDV - ESV

Question 4

what is the common direct effect of all types of shock?

Answer 4

a reduction in mean arterial pressure MAP

Question 5

decrease symp nerve activity - what type?

Answer 5

neurogenic shock

Question 6

vasodilattor release - what type?

Answer 6

anaphylactic or septic shock

Question 7

fluid loss- what type?

Answer 7

hypovolemic shock

Question 8

myocardial failure - what type?

Answer 8

cardiogenic shock

Question 9

what are the four compensatory responses to shock and their outcomes?

Answer 9

1. increase HR
2. increase contractility
3. increase venous tone
4. increase arteriolar tone

HOW? decrease para and increase symp activity

results? increase in MAP , BUT also a decrease in organ blood flow

Question 10

what are the 4 types of shock?

Answer 10

hypovolemic
cardiogenic
distributive
obstructive

Question 11

blood loss or volume loss

Answer 11

hypovolemic shock

Question 12

dysrhythmia or cariomyopathy or mechanical failure

Answer 12

cardiogenic shock aka anything that reduces CO

Question 13

anaphylaactic or septic or neurogenic or drug-induced vasodilation

Answer 13

distributive shock

aka blood doesn’t get back to the heart

Question 14

tension pneumothorax ro pericardial disease or pulmonary embolism

Answer 14

obstructive shock

aka inability to actually fill the heart

Question 15

observe decreased EDV - what type shock?

Answer 15

hypovolemic

this lowers CO so… increase SVR to maintain BP

Question 16

observe: skin cool and pale, reflex thirst activated, sweating

Answer 16

hypovolemic shock or cardiogenic shock (symptoms of symp activity)

Question 17

define crush syndrome:

Answer 17

reperfusion induced injury with increased ions and other products entering and impairing renal function

Question 18

surgical shock and burn shock are examples of..

Answer 18

hypovolemic shock

Question 19

observe: increased ESV and decreased SV

Answer 19

cardiogenic shock

Question 20

tachycardias or bradycardias …

Answer 20

cardiogenic shock (too fast or slow to eject contents properly)

Question 21

3 treatments for cardiogenic shock =

Answer 21

• vasopressors (NE, Dopa, dobutamine)
• revascularization
• balloon pump to improve coronary perfusion and drug delivery

Question 22

how do anaphylasis induce shock?

Answer 22

bronchospasm reduces ventilation and blood pressure is low (systemic vasodilation)

Question 23

observe: high temp, high HR, high RR, high WBC

Answer 23

septic shock

Question 24

observe low SVR

Answer 24

distributive shock

Question 25

“warm shock”

Answer 25

neurogenic or other types of distributive shock

Question 26

what drug overdoses might cause shock?

Answer 26

beta blocker or calcium channel blocker

Question 27

shock with unilateral decreased breath sounds

Answer 27

tension pneumothorax

Question 28

shock with low BP, and elevated right heart pressure

Answer 28

pericardial tamponade

Question 29

shock with chest pain, syncope tachypnea, hypotension with right ventricular overload

Answer 29

pulmonary embolism

Question 30

a reductionin MAP leads to a further reduction in MAP

Answer 30

decompensated shock

Question 31

“cold shock”

Answer 31

hypovolemic shock

Question 32

vasovagal syncope

Answer 32

reflex response to deep pain associated with traumatic injuries inhibits normal sympatatet and accompaining increase in vagal activity

Question 33

how does glycogneolysis play a role in shock?

Answer 33

increased release of glucose from the liver by epi/NE leads to an increses in extracellular osmolarity which will shift fluid into the extracellular space

Question 34

why is BP not an adequate measure of shock

Answer 34

because the compensatory mechanism involve overwhelming arteriolar vasoconstriction, perfusion of tissues other than the heart and brain may be inadequate despite early normal arterial pressure