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Semester 2-CVS > Session 5-Haemodynamic Shock > Flashcards

Session 5-Haemodynamic Shock Flashcards

1
Q

What are the equations for mean arterial blood pressure?

A

MABP = CO x TPR

MABP = SV x HR x TPR

MABP = diastolic pressure + 1/3 pulse pressure

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2
Q

What is haemodynamic shock?

A

Acute condition of inadequate blood flow throughout the body

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3
Q

True or false: shock can be due to fall in CO or fall in TPR beyond capacity of the heart to cope

A

TRUE

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4
Q

How can shock lead to excessive vasodilation?

A

Fall in peripheral resistance

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5
Q

What is cardiogenic shock?

A

Acute failure of the heart to maintain CO - pump failure

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6
Q

What are the potential causes of cardiogenic shock? (3)

A

1) following MI
2) serious arrhythmias
3) acute worsening of heart failure

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7
Q

True or false: central venous pressure may be normal or raised in cardiogenic shock

A

TRUE

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8
Q

Which tissues may be poorly perfused in cardiogenic shock?

A

Coronary arteries

Kidneys

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9
Q

What can poor perfusion of kidneys lead to?

A

Reduced urine production (oliguria)

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10
Q

What is the definition of cardiac arrest?

A

Unresponsiveness associated with lack of pulse

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11
Q

True or false: asystole is loss of electrical and mechanical activity

A

TRUE

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12
Q

What is the most common form of cardiac arrest?

A

Ventricular fibrillation

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13
Q

What are the two types of mechanical shock?

A

Cardiac tamponade

Pulmonary embolism

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14
Q

Which side of the heart does cardiac tamponade affect?

A

BOTH

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15
Q

True or false: cardiac tamponade leads to low central venous pressure but high arterial blood pressure

A

FALSE - high venous and low arterial

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16
Q

Complete the sentences:

Pulmonary embolus occluded a large pulmonary artery, leading to _____ pulmonary artery pressure. The right ventricle cannot empty so central venous pressure is _____ and there is __________ return of blood to left heart. Left atrial pressure is _____, arterial blood pressure is ______ and this leads to shock, chest pain and dyspnoea.

A 
High
High 
Reduced 
Low
Low
17
Q

How might an embolus reach the lungs?

A

Due to deep vein thrombosis, portion breaks off, travels in venous system to right side of the heart and is pumped out via pulmonary artery to lungs.

18
Q

What is hypovolaemic shock?

A

Reduced blood volume, most commonly due to haemorrhage

19
Q

What % of blood loss results in a serious shock response?

A

30-40%

20
Q

What is the severity of shock related to?

A

Amount and speed of blood loss

21
Q

What is the compensatory response for hypovolaemic shock? (5)

A

1) Increased sympathetic stimulation
2) Tachycardia
3) Increased force of contraction
4) Peripheral vasoconstriction
5) Venoconstriction

22
Q

In hypovolaemic shock, what dos increased peripheral resistance do to capillary hydrostatic pressure?

A

Reduces it

23
Q

What are the symptoms of hypovolaemic shock?

A

Tachycardia
Weak pulse
Pale skin
Cold, clammy extremities

24
Q

True or false: hypovolaemic shock can also result from burns and diarrhoea or vomiting (loss of Na+)

A

TRUE

25
Q

How can hypovolaemic shock lead to decompensation (organ failure)?

A

Peripheral vasoconstriction impairs tissue perfusion -

1) tissue damage due to hypoxia
2) release of vasodilators
3) TPR falls
4) BP falls
5) vital organs no longer perfused
6) multi system failure

26
Q

How many days does it take for blood fluid volume to be restored if there has been 20% blood volume loss?

A

About 3 days if salt and water intake are adequate

27
Q

What is distributive shock?

A

Low resistance shock (normovolaemic) due to profound peripheral vasodilation (decreased TPR)

28
Q

What are the two types of distributive shock?

A

Toxic (septic) shock

Anaphylactic shock

29
Q

What are the consequences of toxic/septic shock? (5)

A

1) vasodilation -> fall in TPR
2) fall in arterial pressure
3) impaired perfusion of vital organs
4) leaky capillaries
5) increased coagulation

30
Q

What are the symptoms of septic/toxic shock? (2)

A

1) tachycardia

2) warm, red extremities initially

31
Q

What causes anaphylactic shock?

A

Severe allergic reaction

32
Q

What is released from mast cells during anaphylactic shock and what does this cause?

A

Histamine

Vasodilator effect, fall in TPR
Drop in arterial pressure
Impaired perfusion of vital organs
Bronchoconstriction and laryngeal oedema - difficulty breathing

33
Q

What are the symptoms of anaphylactic shock? (4)

A

1) Difficulty breathing
2) Collapsed
3) Rapid heart rate
4) Red, warm extremities

34
Q

What is given to patients suffering from anaphylactic shock?

A

Adrenaline -> vasoconstriction via action of alpha1-adrenoceptors

35
Q

How can anaphylactic and septic shock lead to multi-organ failure?

A

Distributive shock -> decreased TPR -> decreased BP -> decreased tissue perfusion

OR

Distributive shock -> decreased cardiac output due to leaky capillaries -> decreased blood pressure -> decreased tissue perfusion

36
Q

How can haemorrhage or severe burns lead to multi-organ failure?

A

Hypovolaemic shock -> decreased cardiac output -> decreased blood pressure -> decreased tissue perfusion

37
Q

How can MI or heart failures cause multi-organ failure?

A

Cardiogenic shock -> decreased cardiac output -> decreased blood pressure -> decreased tissue perfusion

38
Q

How can cardiac tamponade or pulmonary embolism lead to multi-organ failure?

A

Mechanical shock -> decreased cardiac output -> decreased blood pressure -> decreased tissue perfusion

Semester 2-CVS (18 decks)

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