Clinical Shock Tables

Question 1

For Ischemic Cardiogenic Shock, starting with decreased perfusion what is the vicious cycle that occurs?

Answer 1

1. decreased perfusion
2. cardiac injury
3. decrease stroke volume
4. increased catecholamines
5. increased heart rate and then back to #1

Question 2

What are the inoconstrictor drugs?

Answer 2

norepi
epi
dopamine

Question 3

What are the inodilator drugs?

Answer 3

dobutamine
dopexamine
isoproterenol

Question 4

What defines severe sepsis?

Answer 4

induced hypotension treatable with fluid resuscitation
elevated lactate
elevated creatinine
elevated bilirubin

Question 5

What treatment for septic shock should be completed within 3 hours?

Answer 5

1. meausre lactate
2. blood culture before ABX
3. administer broad spectrum ABX
4. administer crystalloid if pt has hypotension or high lactate

Question 6

What treatment for septic shock should be completed within 6 hours?

Answer 6

5. apply vasopressers
6. if still hypotensive, meausre central venous pressure and central venous oxygen saturation
7. remeasure lactate

Question 7

If I have:
blood loss <100 bpm
capillary fill is normal
resp rate 14-20
normal extremities 
awake/agitated +

What class hemorrhage is it?

Answer 7

Class 1

Question 8

If I have:
blood loss 750-1500 ml
systolic BP normal
diastolic elevated
pulse >100 bpm
capillary fill >2 sec
resp rate 20-30
pale extremities 
agitated ++

What class hemorrhage is it?

Answer 8

Class 2

Question 9

If I have:
blood loss 1500-2000 ml
systolic BP decreased
diastolic decreased
pulse >120 bpm
capillary fill >2 sec
resp rate 30-40
pale and cool extremities 
disoriented/confused

What class hemorrhage is it?

Answer 9

class 3

Question 10

If I have:
blood loss >2000 ml
systolic BP very low
diastolic not measurable
pulse >140 bpm and weak
capillary fill >2 sec
resp rate >35
pale and cool extremities 
obtunded/lethargic

What class hemorrhage is it?

Answer 10

class 4

Question 11

Pt has Locally limited cutaneous reaction. What class of anaphylactic shock?

Answer 11

class 0

Question 12

Pt has Disseminated cutaneous reaction (flush, pruritus, generalized urticaria), Mucosal reaction (nose, conjunctival) systemic reaction (agitation, headache). What class of anaphylactic shock?

Answer 12

class 1 (mild systemic)

Question 13

Pt has Hemodynamic dysregulation (tachycardia, arrhythmia, hypotension ), mild dyspnea (mild bronchospasm), vomiting, defecation. What class of anaphylactic shock?

Answer 13

class 2 (moderate systemic)

Question 14

Pt has Shock, bronchospasm with severe dyspnea
obtundation, vomiting, defecation. What class of anaphylactic shock?

Answer 14

class 3 (severe systemic)

Question 15

Pt has Respiratory and circulatory arrest. What class of anaphylactic shock?

Answer 15

class 4 (vital organ failure) this is bad soooo sooo bad

Question 16

Decreased cardiac index
increased systemic vascular resistance 
decreased venous capacitance
decreased PCWP
decreased SVO2

What type of hemodynamic shock?

Answer 16

hypovolemic shock

Question 17

increased ++ cardiac index
decreased systemic vascular resistance 
increased venous capacitance
decreased or increased PCWP
decreased or increased SVO2

What type of hemodynamic shock?

Answer 17

septic shock

Question 18

decreased ++ cardiac index
increased ++ systemic vascular resistance 
no change venous capacitance
increased PCWP
decreased SVO2

What type of hemodynamic shock?

Answer 18

cardiogenic shock

Question 19

increased cardiac index
decreased systemic vascular resistance 
no change venous capacitance
decreased PCWP
decreased SVO2

What type of hemodynamic shock?

Answer 19

neurogenic shock