CardioVascular Response To Shock **

Question 1

Hypovolemic Shock can arise from what 3 things?

Answer 1

Haemorrhage

Sever burns

Loss of fluids (Cholera)

Question 2

Low resistance shock can arise from what 2 things?

Answer 2

anaphylaxis

Septic Shock

Question 3

Cardiogenic Shock occurs when?

Answer 3

Heart cannot maintain CO = MI

Question 4

Haemorrhagic Shock

Answer 4

Decreased blood/O2 perfusion of vital organs

results from Loss of Blood Volume

Question 5

What kick starts a Haemorrhagic Shock

Answer 5

Hypovolemic Shock

Question 6

IF blood loss is <15%?

Answer 6

No change

Question 7

If blood loss is 20-30%?

Answer 7

BP severely lowered

Question 8

If blood loss if 30-50%

Answer 8

Irreversible / refractory Severe Shock

Question 9

.>50% Blood loss

Answer 9

Organ Failure

Question 10

What are the 2 Main Immediate Compensation mechanisms for Blood Loss?

Answer 10

Baroreceptors

Peripheral Chemoreceptors

Both Increase SNS

Question 11

What is the purpose of increasing SNS during Blood Loss

Answer 11

Heart Rate Increases

Increased Myocardial Contractility (SV)

Venoconstriction of splanchnic/cutaenous circulation to increase VR

Question 12

What is the 6 Intermediate Compensation mechanisms in place for Blood Loss

Answer 12

RAAS

Atrial Stretch Receptor

Absorption of Interstitial Fluid

Gluconeogenesis

Ventilation Increases

Blood Coagulation Time increases

Question 13

How does RAAS recover BP?

Answer 13

AG2 causes Vasoconstriction

Increase of Thirst

Increase of Na/H20 reabsorption

Question 14

How does Atrial Stretch Receptor affect Vasoconstriction

Answer 14

Blood loss = reduction in atrial stretch receptor activity

ADH / Adrenaline stimulated

Both are vasoconstrictors

Question 15

How does Absoprtion of Interstitual Fluid affect Blood volume?

Answer 15

Vasoconstriction from other mechanisms
=Decrease in Capillary Hydrostatic Pressure (CHP)

Fluid moves from Interestitum to Vasculature

Increasing Blood volume (VR)

Question 16

Why does the liver produce more glucose during blood loss?

What does it lead to in terms of Haem?

Answer 16

Increases Plasma OsM

Water drawn out of cells into vasculature

Leads to Haemodilution / Decrease in Haemocrit

Question 17

Why does the ventilation increase in Blood loss?

Answer 17

Compensate for lack of PO2

Question 18

Why does the Blood coagulation time decrease in Blood loss?

Answer 18

Increase in platelets / Fibrinogen

Any cuts can be quickly sealed to not further lose more blood

Question 19

Name 3 Long term mechanisms for Blood Loss

Answer 19

Reduced Urine Output

Albumin Synthesis

Erythropoesis (RBC creation)

Question 20

Whats the term given when the body reduces Glomerular Filtration rate from SNS

Answer 20

Oliguria

Question 21

How can Body fluid levels be restored?

Answer 21

Drinking

Question 22

Why is Albumin Sythesised with Blood loss?

Answer 22

Affects water potential meaning water will stay in bloodstream and not in cells

Question 23

whats the type of shock called when Blood loss >30%

Answer 23

Progressive Shock

Question 24

what can progressive shock lead to?

Answer 24

Depressed Cardiac Function

Renal Failure

DIC

Hepatic Failure

Question 25

What does someone who is suffering from progressive shock need?

Answer 25

Immediate Transfusion Due to impairment of tissue perfusion

Question 26

What occurs in Refractory Shock

Answer 26

CO falls Irrevocably Irretrievable damage to heart

Question 27

Why do burn patients need plasma and not RBC transfusion

Answer 27

No loss of RBC just plasma in excudate Haemoconcentration decreases

Question 28

Name a type of shock which results from foreign antigens

Answer 28

Anaphylactic Shock