Collapse - 140

Question 1

What is maldistributive shock due to?

Answer 1

Abnormal dilatation of small arteries - commonly due to infections, septic shock, or allergies, anaphylactic shock

Question 2

What is anaphylactic shock and what happens during it?

Answer 2

extreme type 1 hypersensitivity reaction to a previously met antigen. Results in massive degranulation of mast cells which release histamine and other vasoactive substances. Smooth muscle in bronchi contracts, causing oedema, bronchospasm and wheeze.

Question 3

What can be measured to assess the severity of shock?

Answer 3

Blood lactate levels

Question 4

What are some characteristic signs of hypovolaemic shock?

Answer 4

Evidence of fluid loss, patient is dry.

Question 5

What are some characteristic signs of cardiogenic shock?

Answer 5

Chest pain, oedema, ECG rhythm changes

Question 6

What are some characteristic signs of maldistributive shock?

Answer 6

Warm, dilated circulation, sign of sepsis and infection

Question 7

What are some general signs of shock?

Answer 7

Collapse, altered conscious level, tachypnoea, tachycardia, hypotension, poor peripheral perfusion, decreased urine flow. All patients with shock will have signs of organ failure and SNS activation

Question 8

What drug is given as soon as anaphylaxis is confirmed? How is it given?

Answer 8

500mg adrenaline IM

Question 9

What is sepsis?

Answer 9

Systemic inflammatory response to infection -> haemodynamic disturbance and organ dysfunction. Must have 2 or more of the following:
Oral temp >38, or >36
Resp rate >20 or PaCO2 90bpm
WBC > 12,000uL or <4,000uL

Question 10

Name the stages of sepsis, from least to most severe

Answer 10

SIRS (systemic inflammatory response syndrome
Sepsis
Severe sepsis
Hypotension
Septic shock
MODS (multiple organ dysfunction syndrome)

Question 11

What is the mortality rate of sepsis? When does incidence of sepsis increase?

Answer 11

30-50%

Incidence increases with age, longevity in chronic disease, AIDS, Abx use, indwelling catheters etc.

Question 12

What is LPS? What does it do/ what is it’s significance in sepsis?

Answer 12

Endotoxin - one of the main constituents of gram negative cell walls. Acts on TLR4
Binds CD14 on macrophage, causes TNF and IL-1 release. TNF, IL-1 and IL-6 cause microvascular damage, coagulation cascade and oxidative stress