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Pathology Exam 2 > Hemostasis 3 > Flashcards

Hemostasis 3 Flashcards

1
Q

What is shock?

A

cardiovascular collapse

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2
Q

What causes shock? (3)

A
  • insufficient cardiac output
  • loss of circulating blood volume
  • inappropriate vascular resistance (vasodilation)
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3
Q

Pathway of shock

A
  1. decreased cardiac output/effective circulating blood volume
  2. hypotension
  3. decreased tissue perfusion and cellular hypoxia
  4. shift to anaerobic metabolism
  5. cellular degeneration and death
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4
Q

Name the 3 types of shock

A

cardiogenic
hypovolemic
blood maldistribution

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5
Q

What can cause cardiogenic shock? (3)

A

myocardial infarction
cardiomyopathy
arrhythmias

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6
Q

What can cause hypovolemic shock? (2)

A 
blood loss
fluid loss (vomiting, diarrhea, severe burns)
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7
Q

What can cause blood maldistribution? (3)

A

sepsis
anaphylaxis
neurogenic

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8
Q

What are the 3 compensatory mechanisms against shock?

A
  • increased heart rate and contractility
  • peripheral vasoconstriction
  • renal conservation of fluid
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9
Q

What is cardiogenic shock?

A

failure of the heart to adequately pump blood

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10
Q

Characteristics of cardiogenic shock

A
  • increased HR and contractility increases myocardial O2 demand
  • leads to cardiac failure and systemic hypoperfusion
  • systemic hypoperfusion triggers inflammatory cascade
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11
Q

What is hypovolemic shock?

A

reduced circulating blood volume due to fluid loss

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12
Q

Characteristics of hypovolemic shock

A
  • most often due to hemorrhage in domestic animals

- can be seen secondary to severe dehydration

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13
Q

What is septic shock?

A

components of microbes trigger release of excessive quantities of vascular and inflammatory mediators

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14
Q

Causes of septic shock

A
  • LPS from gram negative bacteria

- less commonly, components of gram positive bacteria (peptidoglycan, lipoteichoic acid)

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15
Q

Effects of LPS in septic shock (7)

A
  • activation of endothelial cells
  • activation of inflammatory cells
  • release of inflammatory cytokines
  • activation of coagulation cascade
  • inhibits production of anticoagulant substances
  • activation of platelets
  • activation of complement
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16
Q

General effects of septic shock (5)

A
  • systemic vasodilation
  • diminished myocardial contractility
  • widespread endothelial injury
  • activation of coagulation leading to DIC
  • hypoperfusion leads to multi organ system failure
17
Q

What is anaphylactic shock?

A

generalized type-1 hypersensitivity response

IgE mediated release of vasoactive substances from mast cells

18
Q

General effects of anaphylactic shock

A

systemic vasodilation

increased vascular permeability

19
Q

What is neurogenic shock?

A

widespread loss of vascular tone secondary to spinal cord injury or electrocution

20
Q

Name the 3 stages of shock

A
  1. non-progessive stage
  2. progressive stage
  3. irreversible stage
21
Q

What happens in the non-progressive stage of shock?

A
  • increased cardiac output
  • increased vasoconstriction
  • blood flow maintained to certain tissues
  • stimulation of renin-angiotensin-aldosterone system and release of ADH
22
Q

What happens in the progressive stage of shock?

A
  • pooling of blood
  • hypoperfusion of tissues
  • progressive cell injury
  • anaerobic metabolism
  • acidosis
  • increased CO2
23
Q

What is activated during the progressive stage of shock?

A
  • inflammation
  • coagulation
  • complement
  • fibrinolysis
24
Q

What happens in the irreversible stage of shock?

A
  • membrane transport fails
  • lysosomal contents leak
  • structural integrity of cells is lost
  • cell necrosis
  • multiple organ dysfunction/failure
  • DIC
25
Q

Clinical signs of shock (6)

A 
hypotension
weak pulses
tachycardia
decreased urine production
hyperventilation
hypothermia
26
Q

Lesions of shock (5)

A 
cellular degeneration and necrosis
generalized congestion
edema
hemorrhage (petechia, ecchymoses)
thrombosis

Pathology Exam 2 (5 decks)

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