Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Emergency Medicine > Hypotension > Flashcards

Hypotension Flashcards

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards
1
Q

Why is NEWS chart not always an accurate representation of organ perfusion in hypotensive?

A

If they are naturally very hypertensive then body adapts to a new sitting baseline and therefore a drop by 25% or more in BP can still be very dangerous regardless of NEWS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does DBP contribute to?

A

Coronary perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does MAP contribute to? What is low?

A

Organ perfusion pressure - below 60 is low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do you calculate MAP?

A

MAP = DBP + (SBP - DBP)/3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do you calculate pulse pressure?

A

SBP - DBP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Difference between stroke volume and ejection fraction?

A

Stroke volume is the volume ejected from the left ventricle in systole and ejection fraction is the % of the ventricle that empties on systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What 3 factors effect stroke volume?

A

Preload
Contractility
Afterload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do you optimise preload?

A

IV fluids due to frank starling law

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What negatively effects contractility?

A

Ischaemia, scarring, beta blockers, hypoxia, severe acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What causes an increased afterload?

A

Afterload increased by stenosis, constricted vessels, PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

In hypotensive patient what 6 aspects do you need to take into account in order to modify it?

A 
Heart rate
Rhythm 
Preload
Contractility 
Afterload
SVR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In hypotension what are you looking for regarding a HR or rhythm cause? What do you palpate? tests?

A

Bradycardia, arrhythmia, very tachycardic not allowing filling time
Palpate central pulses
12 lead ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do you assess the preload in a patient? what signs? what do you need to ask about in their recent history?

A

Preload = dehydrated
Signs - mucous membranes, skin turgour, CRT, thirst, UO
History = recent surgery, blood loss, vomiting, diarrhoea, drains with lots in

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do you assess contractility?

A

ECHO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What 2 detrimental effects on the heart does increased afterload have?

A

Increased afterload causes hypertrophy meaning increased oxygen requirements by the heart
Also decreases coronary filling which means less perfusion to heart muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If someone is in AF why is this a risk if their SVR drops?

A

Vasodilation cannot be compensated by an increased HR as the atrial component is lost

17
Q

If someone already has an increased afterload and you give high volume IV fluids what do you risk?

A

Acute left ventricular failure

18
Q

What kind of shock is caused by PE?

A

Obstructive shock

19
Q

What are the 5 (approx) stages from a PE to cardiac arrest?

A

PE causes massive rise in pulmonary venous resistance and pressure which causes huge rise in RV afterload, obstructive shock, the ventricular septum bows towards the LV, causes LV function decline, hypotension and cardiac arrest

20
Q

As well as cardiac arrest what other symptoms of PE will be seen due to pulmonary congestion?

A

SOB
Distended neck veins
Hypoxia

21
Q

Difference in clinical appearance of a patient with low SVR vs high?

A

Low SVR = warm peripheries

High SVR = cold peripheries, clammy, mottled

22
Q

What is the main type of shock that appears with a high SVR?

A

Cardiogenic shock

23
Q

What is the main cause of shock that leads to low SVR?

A

Distributive shock - sepsis

24
Q

If you have hypotension, how can you tell if it is a cardiogenic shock or distributive shock?

A

If the peripheries are warm or not

25
Q

Causes of distributive shock?

A 
Sepsis
Pancreatitis
Anaphylaxis
Burns
Drugs and toxins (transfusion, bites, beta blockers, vasodilators)
Addisonian crisis
Thyrotoxicosis
26
Q

What are the classic 3 signs of addisonian crisis?

A

Hyponatraemia
Hyperkalaemia
Pigmentation

27
Q

Symptoms of severe thyrotoxicosis? What is it often mistaken for?

A 
High output cardiac failure
low SVR
increased temperature
increased HR
Often mistaken for early sepsis
28
Q

How can you monitor the extend of peripheral vasoconstriction on clinical exam?

A

transition points between hot and cold peripheries

Mark and use as monitor for therapy effectiveness

29
Q

What areas of mottling reveal a severe mortality risk?

A

Truncal, upper thigh and genital mottling suggest imminent cardiac arrest

Emergency Medicine (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions