Circulatory Shock/Hypotension

Question 1

What is circulatory shock?

Answer 1

Circulatory shock is a life-threatening condition characterized by inadequate tissue perfusion and oxygenation due to various underlying causes.

Question 2

What is hypotension?

Answer 2

Hypotension is defined as abnormally low blood pressure, often seen in shock.

Question 3

What are the common causes of hypovolemic shock?

Answer 3

Hemorrhage, dehydration, and burns.

Question 4

What are the common causes of cardiogenic shock?

Answer 4

Myocardial infarction, cardiomyopathy, and arrhythmias.

Question 5

What are the common causes of distributive shock?

Answer 5

Septic shock, anaphylactic shock, and neurogenic shock.

Question 6

What are the common causes of obstructive shock?

Answer 6

Pulmonary embolism, cardiac tamponade, and tension pneumothorax.

Question 7

What is the pathophysiology of hypovolemic shock?

Answer 7

Reduced intravascular volume leads to decreased preload and cardiac output.

Question 8

What is the pathophysiology of cardiogenic shock?

Answer 8

Impaired myocardial contractility decreases stroke volume and cardiac output.

Question 9

What is the pathophysiology of distributive shock?

Answer 9

Widespread vasodilation and increased capillary permeability lead to decreased systemic vascular resistance and maldistribution of blood flow.

Question 10

What is the pathophysiology of obstructive shock?

Answer 10

Physical obstruction impedes blood flow, reducing cardiac output.

Question 11

What is the common epidemiology of hypovolemic shock?

Answer 11

Common in trauma, surgical patients, and severe gastrointestinal bleeding.

Question 12

What is the incidence of cardiogenic shock post-myocardial infarction?

Answer 12

About 7-10% in severe cases.

Question 13

Where is septic shock most commonly found, and what is its trend?

Answer 13

Leading cause of death in intensive care units, with increasing incidence due to aging populations and antibiotic resistance.

Question 14

What is a notable trend in anaphylactic shock incidence?

Answer 14

Increasing, particularly due to food allergies and medication reactions.

Question 15

What are common risk factors for circulatory shock?

Answer 15

Severe trauma or surgery, chronic cardiovascular diseases, infections, severe allergic reactions, and prolonged immobilization.

Question 16

What are the clinical features of circulatory shock?

Answer 16

Hypotension, tachycardia, cold and clammy skin, altered mental status, decreased urine output, and metabolic acidosis.

Question 17

What conditions should be considered in the differential diagnosis of circulatory shock?

Answer 17

Heart failure, severe dehydration without shock, adrenal insufficiency, massive pulmonary embolism, and acute abdomen.

Question 18

What patient history aspects are important in diagnosing circulatory shock?

Answer 18

Onset and progression of symptoms, recent trauma or surgery, history of cardiovascular disease, allergies or infections, and medication history.

Question 19

What should be examined in a patient suspected of circulatory shock?

Answer 19

Vital signs, skin condition, jugular venous distention, and lung and heart sounds.

Question 20

What bedside investigations are used for diagnosing circulatory shock?

Answer 20

Electrocardiogram (ECG), point-of-care ultrasound (POCUS), and capillary refill time.

Question 21

What laboratory tests are essential in diagnosing circulatory shock?

Answer 21

Complete blood count (CBC), electrolytes, blood urea nitrogen (BUN), creatinine, lactate levels, arterial blood gas (ABG), and blood cultures.

Question 22

What imaging studies are useful in diagnosing circulatory shock?

Answer 22

Chest X-ray, echocardiography, and CT scan.

Question 23

What are the general measures in managing circulatory shock?

Answer 23

Ensure airway, breathing, and circulation (ABCs), administer oxygen, establish intravenous access, and monitor vital signs continuously.

Question 24

What is the specific management for hypovolemic shock?

Answer 24

Fluid resuscitation with crystalloids or blood products.

Question 25

What is the specific management for cardiogenic shock?

Answer 25

Inotropes (e.g., dobutamine) and mechanical support (e.g., intra-aortic balloon pump).

Question 26

What is the specific management for distributive shock?

Answer 26

Vasopressors (e.g., norepinephrine), antibiotics for septic shock, and epinephrine for anaphylactic shock.

Question 27

What is the specific management for obstructive shock?

Answer 27

Relieve obstruction (e.g., thrombolytics for pulmonary embolism, pericardiocentesis for cardiac tamponade).

Question 28

What supportive care measures are important in managing circulatory shock?

Answer 28

Hemodynamic monitoring, renal function monitoring, and nutritional support.