Lecture 29: Shock and edema Flashcards
What are the 3 key elements of shock?
The 3 key elements to shock are that…
Life threatening condition
Circulatory failure
Inadequate oxygenation
What are the four main types of shock?
The four main type of shock are distributive, hypovolemic, cardiogenic and obstructive.
What component of gram-negative bacteria mediates septic shock?
Lipopolysaccharide (LPS) also frequently called endotoxin is found on the outer membrane of gram-negative bacteria mediating septic shock.
What is the role of adrenomedullin in modulating vascular function?
Adrenomedullin (ADM) enhances endothelial barrier function while in the intravascular compartment.
What is edema?
Edema is an accumulation of fluid in interstitial space of body tissues.
What are the primary drivers of the movement of fluid into and out of vascular space?
The primary drivers of the movement of fluid into and out of vascular space are hydrostatic pressure and colloid osmotic pressure.
What are the mechanisms of edema?
Increased capillary permeability
Increased capillary hydrostatic pressure
Decreased capillary oncotic pressure
Lymphatic obstruction (lymphedema)
What are the causes of the four main types of shock?
Distributive: caused by sepsis, anaphylaxis and neurogenic.
Hypovolemic: caused by hemorrhage, severe burns, severe vomiting, diarrhea.
Cardiogenic: caused by myocardial infarct, ventricular arrhythmia, cardiomyopathy, valvular disease.
Obstructive: caused by cardiac tamponade, pulmonary embolism, pneumothorax.
What are the clinical causes of increased capillary permeability?
Local causes: cellulitis
Systemic causes: sepsis, hypersensitivity reactions
What are the clinical causes of increased capillary hydrostatic pressure?
Local: compartment syndrome and chronic venous insufficiency
Systemic causes: heart failure, renal failure and pregnancy
What are the clinical causes of decreased capillary oncotic pressure?
Systemic causes: protein deficient states
EX: nephrotic syndrome and cirrhosis
What are the clinical causes of lymphatic obstruction (lymphedema)?
Local causes: tumor, trauma and infection
What does transudate and exudate mean?
Transudate: protein poor so mostly water
Exudate: protein rich so loss capillary integrity and potential problem with epithelial tissue
What is the key differential diagnosis for edema?
Weather it is unilateral or bilateral. IF it is a bilateral problem or happening in all limbs then it would systemic vs IF it is a unilateral problem it would happen in 1 leg or locally.
