Practice Questions: Shock Fernandez (MC)

Question 1

Which is true during anaerobic metabolism…a. 36 mmol of ATP are producedb. oxygen is the electron acceptor c. pyruvate is reduced to lactated. increased lactate leads to a metabolic alkalosis

Answer 1

c. pyruvate is reduced to lactate

Question 2

An elevated blood lactate correlates with? a. Increased perfusion of the tissuesb. Decreased perfusion of the tissuesc. Increased aerobic metabolismd. Decreased anaerobic metabolism

Answer 2

b. decreased perfusion of the tissues

Question 3

Which of the following is true regarding shock?a. It is a syndrome characterized by severe clinical signsb. Shock is always irreversible regardless of the causec. It is circulatory failure to supply oxygen and nutrients to meet metabolic and cellular demandsd. All of the Abovee. A and C

Answer 3

e. A and Cshockis a syndrome characterized by severe clinical signsit is circulatory failure to supply O2 and nutrients to meet metabolic and cellular demands

Question 4

Which of the following can lead to shock?a. Increased cardiac pumping efficiencyb. Increased effective circulating volumec. Alterations in vascular toned. Increased oxygen carrying capacity of blood

Answer 4

c. alterations in vascular tone

Question 5

True/False: Patients can only suffer from one type of shock at a time.

Answer 5

False

Question 6

7. Which is false regarding Hypovolemic shock?a. Results from decreased circulating volumeb. Relates to a decrease in the intracellular fluid volumec. Results in decreased tissue perfusiond. Can be due to hemorrhage

Answer 6

b. relates to a decrease in the intracellular fluid volume

Question 7

8. Which of the following is a compensatory mechanism in order to increase blood volume?a. Tachycardia in order to increase COb. Vasodilation in order to allow more space for the bloodc. Increased stroke volume in order to increase COd. Bradycardia in order to conserve the heart

Answer 7

a. tachycardia in order to increase CO

Question 8

9. Why could blood pressure initially be normal in a shock patient?a. The blood pressure machine cannot detect a decrease in BPb. Compensatory mechanisms such as tachycardia, RAAS, and increase in sympathetic tone are hard at workc. It takes at least 24 hours for shock patients to become clinicald. Blood pressure should always be normal even if the patient is in decompensated shock.

Answer 8

b. compensatory mechanisms…….

Question 9

10. The shock organ in the cat is _______ while that of the dog is ________.a. GIT, liverb. Spleen, GITc. Liver, GITd. Liver, kidney

Answer 9

c. Liver for cat and GIT for dog

Question 10

11. Which of the following is a cause of distributive shock?a. Hemorrhageb. Severe vomiting and diarrheac. Anaphylaxisd. Cardiac arrhythmias

Answer 10

c. Anaphylaxis

Question 11

12. Which of the following is not a cause of cardiogenic shock?a. Drugsb. Congestive Heart Failurec. Thromboembolismd. Cardiac tamponade

Answer 11

c. thromboembolism

Question 12

13. Which of the following is true regarding the pathophysiology of cardiogenic shock?a. Ventricular volume and CVP are lowb. Too much blood is entering the heart and therefore too much blood is also leaving the heartc. Fluid is not there to be pushed outd. Cardiac Output is reduced which leads to decreased tissue perfusion

Answer 12

d. CO is reduced leading to decreased tissue perfusion

Question 13

14. True/False. Shock always leads to increased vascular tone (constriction).

Answer 13

False

Question 14

15. True/False. SVR can be either increased or decreased depending on the type of shock.

Answer 14

True

Question 15

16. What are the 3 main categories of shock?

Answer 15

a. Hypovolemicb. Distributive (obstructive)c. Cardiogenic

Question 16

17. What are the perfusion parameters?

Answer 16

a. Mentation-dull, obtunded, depressed. BRAIN NEEDS OXYGEN!b. Mucous Membranes- pale due to decreased perfusionc. Capillary Refill Time-sluggish. Periphery not being perfused in order to perfuse essential tissuesd. Pulse Quality-poor. Not enough SV to fill the vessels.e. Extremity Temperature-Cool extremities due to vasoconstriction of peripheral vessels in order to perfuse essential tissues.f. Heart Rate-Tachycardic bc decreased SV and need to increase CO.

Question 17

18. How are cats going to present differently form dogs?

Answer 17

a. Bradycardic as opposed to tachycardicb. Hypothermicc. Tachypnicd. Hyperdynamic phase in cats is often undetected because cats tend to be stoic. e. Shock organ in a cat is the liver (as opposed to GIT in dog)