A/27 Flashcards
What is shock?
Systemic hypoperfusion
What are causes of shock? (3)
- reduced CO
- reduced circulatory blood volume
- dilation of the peripheral vascular structure
Consequences of shock
- early : reversible cell injury
- late : necrosis
Results of shock (3)
- hypotension
- impaired tissue perfusion
- cellular hypoxia
Types of shock (5)
- cardiogenic shock
- hypovolemic shock
- anaphylactic shock
- neurogenic shock
- septic shock
Causes of cardiogenic shock
- failure of cardiac pump
- outflow obstruction
- diastolic failure
What type of sensitive reaction is anaphylactic shock?
type 1 hypersensitivity reaction
What is neurogenic shock?
loss of vascular tone due to spinal cord injury
What is septic shock?
immune response to endotoxin of microbe
Steps of pathogenesis of septic shock
- endothelial damage
- metabolic defect
- glucocorticoid level increase
What causes endothelial damage in septic shock? (4)
- PAMPs bind macrophage/monocyte system
- Binding releases cytokines
- Cytokines activate and cause injury to endothelial cells
- results are thrombosis, vasodilation, vascular permability
What is the metabolic defect?
Insulin secretion decrease and insulin resistance of tissues cause hyperglycemia
What does hyperglycemia cause in sepis? (2)
- decreased bactericid activity
- accelerated sepsis
Morphology of septic shock (5)
- multiorgan failure
- lipid depletion of adrenal cortex
- acute tubular necrosis
- mucosal hemorrhage and necrosis of GI
- diffuse alveolar damage in the lung
What causes lipid depletion of cells in the adrenal cortex in septic shock?
increased steroid synthesis
