Metabolic Response To Trauma

Question 1

THE BODY RESPONDS TO ALL FORMS OF NOXIOUS STIMULI WITH ______________.

THIS IS A COMPLEX SERIES OF EVENTS THAT VARIES FROM ________ DUE TO A SCRATCH TO _______ and _______ RESPONSES TO SEVERE INJURY.

Answer 1

AN INFLAMMATORY RESPONSE

MILD HYPERAEMIA

MAJOR HAEMODYNAMIC AND METABOLIC

Question 2

THE METABOLIC RESPONSE TO INJURY BECOMES CLINICALLY IMPORTANT ONLY WHEN ____________

Answer 2

THE INJURY IS SEVERE.

Question 3

THE PHASES OF THE METABOLIC RESPONSE TO INJURY
THE RESPONSES ARE DIVIDED INTO TWO: THE _____ AND THE ____

Answer 3

EBB

FLOW

Question 4

THE EBB

THIS PERIOD IS USUALLY (SHORT or LONG?) AND CORRESPONDS TO ________ RESULTING FROM _____________.

Answer 4

short

CLINICAL SHOCK

REDUCED TISSUE PERFUSION

Question 5

THE ______ OF THE ____ PHASE DETERMINES CLINICAL OUTCOME.

Answer 5

SEVERITY

EBB

Question 6

IF THE EBB PHASE IS __________ PATIENTS WILL HAVE AN UNCOMPLICATED TRANSITION TO THE FLOW PHASE.

Answer 6

MILD OR MODERATE

Question 7

HOWEVER IF EBB PHASE IS SEVERE PATIENTS DEVELOP THE _________________________________

Answer 7

SYSTEMIC INFLAMMATORY RESPONSE SYNDROME (SIRS)

Question 8

THE SYSTEMIC INFLAMMATORY RESPONSE SYNDROME (SIRS)

CRITERIA FOR DIAGNOSIS of SIRS

TEMPERATURE ______ or _____

HEART RATE ___/MIN

RESPIRATORY RATE ____/MIN

PCO2 ___mmHg (< 4.3kPa) or ventilated

WBC count ________ or ______ mm3

Answer 8

> 38 C or <36 C.

> 90

> 20

<32

> 12000 or < 4000

Question 9

In SIRS

THE UNDERLYING MECHANISMS HAVE YET TO BE CLARIFIED.

T/F

Answer 9

T

Question 10

SIRS

_____ THERAPEUTIC STRATEGIES HAVE BEEN FOUND TO BE HELPFUL BECAUSE _________

Answer 10

NO

UNDERLYNG MECHANISMS ARE NOT QUITE CLEAR.

Question 11

DERANGED PARAMETERS IN SIRS

LOW LEVELS OF THE FOLLOWING;

_______,______,________

DISORDERED HORMONAL REGULATION EG LOW ___,____,______

NEARLY ALL OF THESE PATIENTS DEVELOP ——-

Answer 11

ALBUMIN, ZINC IRON AND SELENIUM

TSH, T4 AND T3.

SIAD.

Question 12

The flow phase

THE FLOW PHASE MAY LAST FOR _____ to ____ DEPENDING ON THE EXTENT OF THE INJURY.

Answer 12

DAYS TO WEEKS

Question 13

The flow phase

IN THIS PHASE METABOLISM IS ALTERED TO ENSURE THAT ____________________ AT THE EXPENSE OF ________________

Answer 13

ENERGY IS AVAILABLE FOR DEPENDENT TISSUES

MUSCLE AND FAT STORES.

Question 14

The flow phase

INCREASE IN THE FOLLOWING; GLYCO________, _______, ______,______

Answer 14

GENOLYSIS

GLUCONEOGENESIS

LIPOLYSIS

PROTEOLYSIS.

Question 15

ACUTE PHASE PROTEIN RESPONSE

THIS LEADS TO _______ PRINCIPALLY BY THE _____ OF A NUMBER OF PLASMA PROTEINS ALONG WITH DECREASE IN CONCENTRATION OF OTHERS.

Answer 15

DE NOVO SYNTHESIS

LIVER

Question 16

Acute phase response protein

THIS RESPONSE IS STIMULATED BY THE RELEASE OF CYTOKINES SUCH AS INTERLEUKIN 1 and 6 and TNF, tumor necrosis factor, and raised concentrations of _____, and ____

Answer 16

cortisol and glucagon.

Question 17

THE ACUTE PHASE PROTEINS ARE USED TO monitor THE COURSE OF THE INFLAMMATORY PROCESS IN THE PATIENT.
MEASURING ______ USED TO MONITOR CHANGES ON A DAILY BASIS.

Answer 17

C- REACTIVE PROTEIN (CRP)

Question 18

MEASUREMENT OF ERYTHROCYTE SEDIMENTATION RATE. ESR.

THIS REFLECTS _______ and ——- CONCENTRATION.
ESR CHANGES SLOWLY SO CAN BE USED TO MONITOR INFLAMMATION OVER WEEKS.

Answer 18

FIBRINOGEN AND IMMUNOGLOBULIN

Question 19

In normal stress response, the immune system is _______

Answer 19

Supressed

Question 20

The ebb phase lasts for ________

The flow phase lasts for ______

Answer 20

24-48hrs

Days to weeks

Question 21

Between ebb and flow, which is energy dependent

Answer 21

Flow!

Question 22

In ebb phase, there is

_____ease cardiac output
_____ease respiratory rate
______ease blood glucose

Answer 22

Decrease
Decrease
Decrease

Question 23

In flow phase, there is

_____ease in catecholamine levels

_____ease in glucocorticoid levels

_____ease in glucagon levels

Answer 23

Incr
Incr
Incr

Question 24

Acute phase protein production is in which phase

Answer 24

Flow

Question 25

Metabolic response in ebb and flow phase

Blood glucose level
Glucose production
Free fatty acid level
Insulin concentration
Catecholamines

Answer 25

Increase ; N or increase
N; Increase
Increase;N or increase
Decrease; N or increase
Increase; increase

Question 26

Metabolic response in ebb and flow phase

Glucagon
Blood lactate level
Oxygen consumption
Cardiac output
Core temperature

Answer 26

Increase; increase

Increase; N

Decrease; Increase

Decrease; increase
Decrease; increase

Question 27

Metabolic response to over feeding

Hyper
Hyper
Hyper
Hypo
Hypo
Hypo
Fatty liver

Answer 27

Glycemia
Capnia
Triglyceridemia
Phosphotemia
Magnesemia
Kalemia

Question 28

Trauma or critically ill patients should be overfed

T/F

Answer 28

F

Question 29

In shock , there are

_______ respiratory rate

_____tension/ _____volemia

_____pneoa

Answer 29

Increased

Hypo; hypo

Tachy

Question 30

In EBB phase

_____volemia
(High or low?) pulse rate
Oxygen consumption is (high or low?)
BMR is (high or low?)
Dehydration or over hydration?
Glucose levels are (high or low?)
Cardiac output is (high or low?)

Answer 30

Hypo

Low

Low

Low

Dehydration

Low

Low

Question 31

Mild hemorrhage- ____% blood loss

Moderate hemorrhage- ____% blood loss

Severe hemorrhage- ____% blood loss

Answer 31

5-10

10-30

Above 30