Sepsis and Shock

Question 1

what are the 4 types of shock

Answer 1

hypovolaemic, cardiogenic, distributive, obstructive

Question 2

why does shock occur

Answer 2

when metabolic needs of cells are not met because of inadequate blood flow

Question 3

what happens in hypovolaemic shock

Answer 3

decreased venous return, decreased preload, reduction in circulatory volume, decreased cardiac output, decreased stroke volume, lower BP, perfusion failure and tissue hypoxia, organ dysfunction, multiorgan failure

Question 4

causes of hypovolaemic shock

Answer 4

trauma, oesophageal varices, lower GI bleed, PR bleed, aortic aneurysm, dehydration, burns

Question 5

what happens in cardiogenic shock

Answer 5

failure of the heart as a pump, loss of cardiac output so lower BP

Question 6

causes of cardiogenic shock

Answer 6

major MI, severe left ventricular failure- ischaemic heart disease

Question 7

what happens in distributive shock

Answer 7

inadequate tissue perfusion due to lack of normal responsiveness of blood vessels to vasoconstrictive agents, direct vasodilation, drop in systematic vascular resistance and stroke volume, generalised vasodilation which causes BP to drop, therefore reduced cardiac output and venous return, tissues dont get enough blood supply leading to tissue hypoxia

Question 8

what are the 3 subtypes of distributive shock

Answer 8

septic, anaphylactic, neurogenic

Question 9

what happens in septic shock

Answer 9

generalised infection that spreads, massive vasodilation increases capillary permeability, causing fluid to leak into the interstitial spaces, this causes a reduced volume in the vessel, decreased systemic vascular resistance, therefore reduced BP, lower venous return, lower cardiac output, tissue does not get enough oxygen

Question 10

what happens in anaphylactic shock

Answer 10

overactivation of immune response, massive release of histamine from mast cells, histamine causes vasodilation, increased prostaglandin release, systematic vasodilation

Question 11

what happens in neurogenic shock

Answer 11

vasomotor centre in the medulla affected so loss of vasomotor tone and sympathetic activity, causes vasodilation, when VMC is unable to maintain tone of vessels the vessels relax, vasodilation, pressure reduces

Question 12

what happens in obstructive shock

Answer 12

a blockage in the flow of blood to the heart or major blood vessels- causes cardiac tamponade, pulmonary embolism, tension pneumothorax