Shock 1

Question 1

Hypovolemic shock

• ?- revealed or concealed (? bones/chest/abdo/pelvis).
• Dehydration- severe ?/?, DKA (?), ? (losses into blisters/ weeping skin), bowel obstruction (? ? accumulation).

Answer 1

haemorrhage
long
vom/diarrhoea
polyuria
burns
third space

Question 2

Distributive shock

?.
?.
? shock

Answer 2

sepsis
anaphylaxis
neurogenic

Question 3

Cardiogenic shock . .

Direct ? failure: ??, arrhythmias, ?dysfunction, ? disturbances

Answer 3

pump
MI
valve
metabolic

Question 4

Obstructive shock. . .

- Indirect ? failure: ? PE, cardiac ?, ?pneumothorax.

Answer 4

pump
massive
tamponade
tension

Question 5

Essential features of any kind of shock
-fall in ? by at least ? (usually ? <90)
? (due to catecholamine release)
? (due to met acid caused by tissue hypoxia)

Answer 5

bp
40
SBP
tachycardia
tachypnoea

Question 6

In hypovolemic / cardiogenic shock the patient is ?, ? and ? with a rapid ‘?’ pulse. Pulse pressure will be ? due to ?.

In septic shock, the patient is ?, ? and ? with a rapid ‘?’ pulse.
Pulse pressure will be ? due to ?

Answer 6

cold, pale, clammy, thready, narrow, vasoconstriction

hot, flushed, sweaty, bounding, wide, vasodilatation

Question 7

Cerebral: Autoregulation over MeanAP of ?-?mmHG, but below this threshold the
patient will become agitated, ?, ? and eventually unresponsive.

Cardiac: Reduced ? pressure leads to inadequate myocardial ?, leading to ? chest pain, ? and eventually infarction.

Respiratory: ? respiratory rate due to metabolic ?.

Answer 7

50-150
confused
drowsy
diastolic
perfusion
ischaemic
arrhythmias
increased
acidosis

Question 8

Renal: Autoregulation over MeanAP of 70-170, but below this there will be ? which ultimately leads to impaired renal function (? build up).

GI: Decreased gut ? and nutrient ?, and decreased ability to sustain normal ?, leading to ? susceptibility.

Skin: Blood supply is ?, giving cool/ clammy/ ? peripheral skin.

Answer 8

oliguria
toxin
motility
absorption
flora
infection
centralized
mottled