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cpr 2 exam 1 > Clinical Cardiac Part 5 > Flashcards

Clinical Cardiac Part 5 Flashcards

1
Q

What are the main physiologic determinants of tissue perfusion?

A

Cardiac output

Systemic vascular resistance

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2
Q

What is the equation for BP?

A

BP= CO x SVR

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3
Q

What is the equation for cardiac output?

A

CO= HR x SV

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4
Q

What is stroke volume determined by?

A

1) Preload
2) Myocardial contractility
3) Afterload

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5
Q

What is shock?

A

Inadequate tissue perfusion to meet metabolic demand and tissue oxygenation

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6
Q

How is shock classified according to stage?

A

Compensated
Decompensated
Irreversible

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7
Q

How is shock classified according to physiology?

A

Cardiogenic
Hypovolemic
Distributive
Obstructive

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8
Q

How is shock classified according to what actually caused it?

A

Septic
Neurogenic
Hemorrhagic
Anaphylactic

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9
Q

What is compensated shock?

A

Reflex compensatory mechanism activated and BP to vital organs is maintained

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10
Q

Is there a decrease in BP with compensated shock?

A

No

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11
Q

What happens in compensated shock?

A 
Sympathetic vascular tone is increased
Release of catacholamines
RAAS activated
HR increased
Contractility increased
Blood vessels contract shunting blood centrally
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12
Q

What is decompensated shock?

A

Issue hypoperfusion and onset of worsening circulatory and metabolic derangment including lactic acidosis
Hypotension
Lactic acidosis

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13
Q

Is there a decrease in BP with decompensated shock?

A

Yes

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14
Q

What is irreversible shock?

A

Organ and tissue injury is so severe that even if the hemodynamic defects are corrected survival is not possible

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15
Q

Is compensated shock progressive?

A

No

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16
Q

Is decompensated shock progressive?

A

Yes

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17
Q

What are the causes of septic distributive shock?

A 
Gram positive
Gram negative
Fungal
Viral
Parasitic
Myocobacterium
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18
Q

What are non-septic causes of distributive shock?

A

Inflammatory shock
Neurogenic shock
Anaphylactic shock

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19
Q

What are cardiomyopathic causes of cardiogenic shock?

A

MI
Myocarditis
Beta-blocker induced

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20
Q

What are arrhythmogenic causes of cardiogenic shock?

A

Tachyarrythmia

Bradyarrhythmia

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21
Q

What are mechanical causes of cardiogenic shock?

A

Valvular insufficiency
Valvular rupture
Valve stenosis

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22
Q

What are hemorrhagic causes of hypovolemic stroke?

A

Trauma
GI bleeding
Retroperionteal bleeding

23
Q

What are non-hemorrhagic causes of hypovolemic shock?

A 
Third space losses into the extravascular space or body cavities
GI losses (vomiting)
24
Q

What are pulmonary vascular causes of obstructive shock?

A

Hemodynamically significant PE

Pulmonary HTN

25
Q

What are the mechanical causes of obstructive shock?

A

Tension pneumothorax

Pericardial tamponade

26
Q

What are mixed causes of shock?

A

Adrenal insufficiency
Thyrotoxicosis
Acidosis
Hypothermia

27
Q

Cardiogenic shock is what?

A

Bad pump

28
Q

Hypovolemic shock is what?

A

Decreased intravascular volume

29
Q

Distributive shock is what?

A

Dilated peripheral vasculature (decreased SVR)

30
Q

Obstructive shock is what?

A

Mechanical obstruction of circulatory system

31
Q

What is cardiac output in cardiogenic shock?

A

Decreased

32
Q

What is SVR in cardiogenic shock?

A

Increased

33
Q

What is PCWP or CVP in cardiogenic shock?

A

Increased

34
Q

What is cardiac output in hypovolemic shock?

A

Decreased

35
Q

What is SVR in hypovolemic shock?

A

Increased

36
Q

What is PCWP or CVP in hypovolemic shock?

A

Decreased

37
Q

What is cardiac output in septic and anaphylactic distributive shock?

A

Increased

38
Q

What is SVR in septic and anaphylactic distributive shock?

A

Decreased

39
Q

What is PCWP or CVP in septic and anaphylactic distributive shock?

A

Decreased

40
Q

What is the cardiac output in neurogenic distributive shock?

A

Decreased

41
Q

What is SVR in neurogenic distributive shock?

A

Decreased

42
Q

What is PCWP or CVP in neurogenic distributive shock?

A

Decreased

43
Q

What is cardiac output in obstructive shock?

A

Decreased

44
Q

What is SVR in obstructive shock?

A

Increased

45
Q

What is PCWP or CVP in obstructive shock?

A

Variable

46
Q

What is an example of third spacing that resulting in hypovolemic shock?

A

Cirrhosis

47
Q

What is an example of hypovolemic shock through the skin?

A

Burns

48
Q

What is an example of dehydration hypovolemic shock?

A

Vomiting, diarrhea, decreased intake

49
Q

What causes distributive shock?

A

Vasodilation of the vascular beds causes decreased systemic vascular resistance

50
Q

What are signs of shock?

A 
Hypotension
Tachycardia
Oliguria
Abnormal mental status
Tachypnea
Cool, clammy, cyanotic skin
Metabolic acidosis
Elevated serum lactate
51
Q

How do you stabilize a patient with shock?

A 
Airway
Breathing
Circulation
Disability (neuro)
Exposure (check the back and the "nether" regions)
*Primary survey
52
Q

How do you treat shock?

A

IVF (in bolus)
Vasopressors
US evaluation
Broad spectrum antibiotics if infection (sepsis) thought to be cause

53
Q

What is unique about shock in kids?

A

Don’t see hypotension until the very end

54
Q

What is unique about shock in the elderly?

A

Medications mask the symptoms

cpr 2 exam 1 (20 decks)

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