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Y3R4 - BMS 🏥 > L9: Hemorrhage > Flashcards

L9: Hemorrhage Flashcards

1
Q

etiology of Hemorrhage

A
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2
Q

Pathophysiology of Hemorrhage

A
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3
Q

Importance of local response in Hemorrhage

A

Stopping the bleeding.

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4
Q

what does local resonse in Hemorrhage include?

A
  • Immediate VC.
  • Retraction of intima of injured vessel.
  • Subsequent blood clotting.
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4
Q

Importance of Systemic Response in Hemorrhage

A
  • Maintaining effective circulatory volume & perfusion of critical tissues (Brain & Heart) at the expense of less critical tissues (skin, skeletal muscle & splanchnic area.
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5
Q

what does Systemic Response in Hemorrhage include?

A
  • Neural factors (Rapid)
  • Endocrinal Factors (Slow)
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6
Q

Neural factors Systemic Response to Hge

A
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7
Q

Endocrinal factors Systemic Response to Hge

A
  • Catecholamines
  • Anti-insulins
  • RAAS system
  • Vasopressin (ADH)
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8
Q

Catecholamines Systemic Response to Hge

A
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9
Q

Anti-insulins Systemic Response to Hge

A
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10
Q

RAAS System Systemic Response to Hge

A
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11
Q

Vasopessin (ADH) Systemic Response to Hge

A
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12
Q

Classification in Hemorrhage

A

According to:

  • site
  • Source
  • Time of occurence
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13
Q

Classification in Hemorrhage according to site

A
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14
Q

Classification in Hemorrhage according to source

A
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15
Q

Classification in Hemorrhage acc to time of occurence

A
16
Q

Clinical Features of Hemorrhage

A
17
Q

Classes of Hemorrhage

A
18
Q

Investigations in Hemorrhage

A
  • Clinically
  • Urinary Catheter
  • CVP
  • PAWP
  • Arterial Canulation
  • Blood Gases
  • Blood Studies
  • ECG
19
Q

Clinical investigation in Hemorrhage

A
20
Q

what is Normal urine output?

A

0.5 - 1 ml/kg/h

21
Q

Def of Central Venous Pressure (CVP)

A

Venous pressure in right atrium

22
Q

Importance of Central Venous Pressure (CVP)

A

As long as cardiac function is normal it reflects:
- Volume of blood returning to heart.
- The ability of heart to expel it.

23
Q

Normal Range of Central Venous Pressure (CVP)

A

5-15 cm H2O (if zero is the mid axillary line)

24
Q

what does Central Venous Pressure (CVP) indicate?

A
  • High perfusion indicates over transfusion & possibility of pulmonary edema
  • Low pressure indicates hypovolemia.
25
Q

Pulmonary Artery Wedge Pressure (PAWP) is measured by ……

A
  • Swan-Ganz catheter through Jugular or antecubital vein
26
Q

Importance of Pulmonary Artery Wedge Pressure (PAWP)

A
27
Q

Site of Arterial Canulation

A

Radial artery

28
Q

Importance of Arterial Canulation

A
  • Determination of blood pressure.
  • Sampling of arterial blood.
29
Q

Blood gases, normal value & effects of hge shock

A
30
Q

ECG

A

to detect any arrythmia.

30
Q

what do blood studies include?

A

Hb% - hematocrit - electrolytes - urea - creatinine.

31
Q

TTT of Primary External Hemorrhage

A
32
Q

TTT of Reactionary Hemorrhage

A

Re-explore the wound & control the bleeding.

33
Q

what is

What is the Most serious complication of septic wounds?

A

Secondary Hemorrhage

34
Q

Characters of Secondary Hemorrhage

A

Hemorrhage is usually arterial & often preceded by slight bleeding.

Needs urgent treatment:
* Fresh blood transfusion & other anti-shock measures.
* Umbrella of antibiotics.
* Explore bleeding vessel within the wound.
* Apply ligatures above & below the clot then resect the vessel in between.

If source of bleeding cannot be identified, wound is tightly packed with gauze over which a pressure bandage is applied for 48 hours

35
Q

what should happen after TTT of Secondary Hemorrhage?

A

Y3R4 - BMS 🏥 (18 decks)

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