Metabolic Response To Trauma Flashcards
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.
AN INFLAMMATORY RESPONSE
MILD HYPERAEMIA
MAJOR HAEMODYNAMIC AND METABOLIC
THE METABOLIC RESPONSE TO INJURY BECOMES CLINICALLY IMPORTANT ONLY WHEN ____________
THE INJURY IS SEVERE.
THE PHASES OF THE METABOLIC RESPONSE TO INJURY
THE RESPONSES ARE DIVIDED INTO TWO: THE _____ AND THE ____
EBB
FLOW
THE EBB
THIS PERIOD IS USUALLY (SHORT or LONG?) AND CORRESPONDS TO ________ RESULTING FROM _____________.
short
CLINICAL SHOCK
REDUCED TISSUE PERFUSION
THE ______ OF THE ____ PHASE DETERMINES CLINICAL OUTCOME.
SEVERITY
EBB
IF THE EBB PHASE IS __________ PATIENTS WILL HAVE AN UNCOMPLICATED TRANSITION TO THE FLOW PHASE.
MILD OR MODERATE
HOWEVER IF EBB PHASE IS SEVERE PATIENTS DEVELOP THE _________________________________
SYSTEMIC INFLAMMATORY RESPONSE SYNDROME (SIRS)
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
> 38 C or <36 C.
> 90
> 20
<32
> 12000 or < 4000
In SIRS
THE UNDERLYING MECHANISMS HAVE YET TO BE CLARIFIED.
T/F
T
SIRS
_____ THERAPEUTIC STRATEGIES HAVE BEEN FOUND TO BE HELPFUL BECAUSE _________
NO
UNDERLYNG MECHANISMS ARE NOT QUITE CLEAR.
DERANGED PARAMETERS IN SIRS
LOW LEVELS OF THE FOLLOWING;
_______,______,________
DISORDERED HORMONAL REGULATION EG LOW ___,____,______
NEARLY ALL OF THESE PATIENTS DEVELOP ——-
ALBUMIN, ZINC IRON AND SELENIUM
TSH, T4 AND T3.
SIAD.
The flow phase
THE FLOW PHASE MAY LAST FOR _____ to ____ DEPENDING ON THE EXTENT OF THE INJURY.
DAYS TO WEEKS
The flow phase
IN THIS PHASE METABOLISM IS ALTERED TO ENSURE THAT ____________________ AT THE EXPENSE OF ________________
ENERGY IS AVAILABLE FOR DEPENDENT TISSUES
MUSCLE AND FAT STORES.
The flow phase
INCREASE IN THE FOLLOWING; GLYCO________, _______, ______,______
GENOLYSIS
GLUCONEOGENESIS
LIPOLYSIS
PROTEOLYSIS.
ACUTE PHASE PROTEIN RESPONSE
THIS LEADS TO _______ PRINCIPALLY BY THE _____ OF A NUMBER OF PLASMA PROTEINS ALONG WITH DECREASE IN CONCENTRATION OF OTHERS.
DE NOVO SYNTHESIS
LIVER
