Hypotension/Shock

Question 1

what are the types of shock

Answer 1

1. obstructive
2. cardiogenic
3. distributive
4. hypovolemic

Question 2

what can cause hypovolemic shock

Answer 2

hemorrhage
third space loss
other loss like GI or skin

Question 3

what can cause cardiogenic shock

Answer 3

myopathy–ischemic, dilated
rhythm abnormalities
mechanical

PE
pulm hypertension
tension pneumo
pericardial tamponade 
aortic dissection

Question 4

what can cause distributive shock

Answer 4

sepsis
anaphylaxis
carbon monoxide
myxedema

Question 5

what investigations should you do in the setting of shock

Answer 5

CBC 
lytes
liver function
renal function
amylase/lipase
fibrinogen 
lactate
cardiac enzymes
arterial blood gasses
toxicology
UA
ECG
CXR or other diagnostic imaging

Question 6

how do you manage shock

Answer 6

ABCs
stabilize patient
treat underlying cause
recommend admission to ICU for patients in need of specialized care or consultation

Question 7

definition of shock

Answer 7

state of cellular and tissue hypoxia due to reduced oxygen delivery and/or increased oxygen consumption or inadequate oxygen utilization

most commonly occurs when there is circulatory failure manifested as hypotension

Question 8

what is the most common form of shock

Answer 8

septic (distributive)

obstructive is rare

Question 9

define sepsis

Answer 9

lief threatening organ dysfunction due to dysregulated host response to infection

Question 10

define septic shock

Answer 10

persisting hypotension requiring vasopressors to maintain a mean arterial pressure of 65mmHg or higher and a serum lactate above 2 despite adequate volume resuscitation
–no longer need SIRS to have sepsis