Hypertension And Shock Flashcards
Where can blood pressure be regulated?
Heart
Kidneys
Vasculature
Treatment of hypertension
Diuretics
Vasodilators eg alpha 1 R antagonist/ calcium blockers
ACE inhibitors - block angiotensin II and reduce aldosterone release
Beta blockers (phasing out)
What is blood pressure in hypertension?
Over 140/90
What is hypovolaemic shock?
Loss of circulating volume
After what blood loss will someone start to show signs of hypovolaemic shock
Reduction by 20-30%
Give some causes of hypovolaemic shock.
Hyponatraemia Vomiting Diarrhoea Burns Haemorrhage
Where are baroreceptors found?
Arch of aorta
Carotid sinus
What are the signs and symptoms of hypovolaemic shock?
Cold and clammy
Tachycardia
Weak pulse
What is the long term consequence of SNS stimulation in hypovolaemic shock?
Activation of the RAAS
ADH release
What effect does increased TPR have in hypovolaemic shock?
Impairs tissue perfusion (increase in vasodilator metabolites can override this)
Reduced hydrostatic pressure
Internal transfusion
What is anaphylactic shock?
A form of distributive shock caused by an allergic reaction
What chemical mediators can be released in anaphylactic shock?
Leukotrienes Bradykinin Histamine Prostaglandins Cytokines
What affect does histamine have in anaphylactic shock?
Decreased arterial blood pressure
Reduced TPR
What are the signs and symptoms of anaphylactic shock?
Dyspnea Collapse Tachycardia Red and warm extremities Fast and pounding pulse
How do you treat anaphylactic shock?
Adrenaline
What is toxic shock?
A form of distributive shock caused by sepsis.
What bacterial and endogenous chemicals contribute to the symptoms of toxic shock?
Endotoxin
TNF alpha
IL-1
What are the symptoms of toxic shock?
Tachycardia
Warm and red extremities
Strong pulse
How can you treat toxic shock?
Antibiotics
Fluid resuscitation with colloid
Give a cause of mechanical shock
Cardiac tamponade
Pulmonary embolism
What are the symptoms of mechanical shock
Dyspnoea Chest pain Raised JVP Bulging neck veins Tachycardia
What are the pressures in the right and left atria in mechanical shock caused by a pulmonary embolism?
(high or low)
Right - high
Left - low
What are the pressures in the right and left atria in mechanical shock caused by cardiac tamponade?
(high or low)
Right - high
Left - high
How would you treat cardiac tamponade?
Pericardiocentesis beneath the xiphoid process
What is cardiogenic shock?
Inability of the heart to eject enough blood
Give some causes of cardiogenic shock
Ventricular tachycardia
Bradycardia
MI which damages the left ventricle
Acute worsening of heart failure
How can cardiogenic shock cause oliguria?
Pressure is too low to filter blood through the kidneys
