Blood flow, abnormal local variations and clinical presentations Flashcards
22 y/o woman with abdominal pain and fever, pain started generalised and now worse in RIF, BP is 85/55 HR 119
Septic shock
50% rise of serum creatinine in last week is acute kidney injury
Mechanism of septic shock and example
Driven by vasodilation due to systemic inflammation - e.g. bacteraemia
Mechanism of cariogenic shock and example
Poor cardiac output due to pump failure = low BP
E.g. heart failure and bradycardia
Neurogenic shock mechanism and e.g.
Excessive P/s or deficient S response
e.g. blood loss
Hypovolemic shock and sx
Reduced blood volume = reduced pump efficacy and pressure
Blood loss is e.g.
Anaphylactic shock mechanism and e.g.
Massive histamine and IgE response = inflammation
Anaphylaxis is e.g.
Obstructive shock mechanism and e.g.
Blockage in major vessel = increased BP
E.g. includes aortic stenosis and PE
Ohm’s law calculations
- Blood pressure = blood flow (cardiac output) x peripheral resistance
- Cardiac output = heart rate x stroke volumr
- BP = heart rate x stroke volume x peripheral resistance
Why is noradrenaline essential in times of stress?
Constricts non-essential vessels e.g. GIT but dilates essential vessels = higher BP
58 y/o man is drowsy and confused, temp is 38.4, HR 112, BP 90/72, sats 86%
CAP by streptococcus pneumonia and sepsis
SEPSIS 6 = BUFALO
Breathlessness and dizziness on exertion, O/E normal obs with ejection systolic murmur and slow rising pulse
Aortic stenosis
Diagnose echocardiography
Treat valve replacement t
STEMI treatment
PCI (Stent)
ACEi (ramipril), B blockers, aldosterone antagonist etc
Pain in both calves, feet are cold and weak pedal pulses
Intermittent claudication (In DVT would be one leg) Manage with reducing risk factors, exercise and analgesia
Timeframe of TIA
Lasts less than 24h
How do the different strokes appear on CT?
Ischaemic acute stroke would initially look normal on CT
Strokes only show on CT after a few dyas
Haemorrhagic stroke is visible on CT straight away
