Shock

Question 1

What is the top priority of the circulatory system?

Answer 1

Maintain perfusion (blood pressure/flow) to vital organs

Question 2

Perfusion is essentially equivalent to?

Answer 2

Blood pressure (BP)

Question 3

What are the determinants of Perfusion (BP)?

Answer 3

Cardiac output (CO) = HR X SV
Systemic Vascular Resistance (SVR)
-- BP = CO X SVR

Question 4

What determines the stroke volume?

Answer 4

Preload
Afterload
Contractility

Question 5

What is Shock?

Answer 5

Inadequate tissue perfusion (BP) to meet metabolic and oxygenation demands

Question 6

What is Shock?

Answer 6

Inadequate tissue perfusion (BP) to meet metabolic/oxygenation demands

Question 7

If Shock is categorized by stage, what are the stages?

Answer 7

1. Compensated
2. Decompensated
3. Irreversible

Question 8

Compensated Shock

Answer 8

Compensatory mechanisms (+) and perfusion is maintained
= HR elevated and peripheral vessels constrict to shunt blood centrally

Question 9

Decompensated Shock

Answer 9

Hypotension and Lactic Acidosis

Question 10

Irreversible Shock

Answer 10

Organ and tissue injury are too severe for survival

Question 11

If Shock is categorized by physiology, what are the options?

Answer 11

1. Cardiogenic
2. Hypovolemic
3. Distributive
4. Obstructive

Question 12

If Shock is categorized by physiology, what are the options?

Answer 12

1. Cardiogenic
2. Hypovolemic
3. Distributive
4. Obstructive

Question 13

Cardiogenic Shock

Answer 13

• Due to a bad pump
  CO = decreased
  SVR and CVP = increased

Question 14

What usually causes Cardiogenic shock?

Answer 14

Heart muscle problems (cardiomyopathies),

rhythm problems, valvular/congenital issues

Question 15

Hypovolemic Shock

Answer 15

• Due to decreased intravascular volume
  CO = decreased
  SVR = Increased
  CVP = decreased

Question 16

What usually causes Hypovolemic Shock?

Answer 16

Blood loss

Non-hemorrhagic = dehydration, cirrhosis, burns

Question 17

Distributive Shock

Answer 17

Dilated peripheral vasculature
CO = increased
SVR and CVP = decreased

Question 18

What are some causes of Distributive Shock?

Answer 18

Neurogenic (brain/spinal cord injury)
Septic
Anaphylactic
Toxins

Question 19

What are some causes of Distributive Shock?

Answer 19

Neurogenic (brain/spinal cord injury)
Septic
Anaphylactic
Toxins

Question 20

CO, SVR and CVP levels for Distributive Shock besides Neurogenic

Answer 20

CO = increased
SVR and CVP = decreased
– Neurogenic = ALL DECREASED

Question 21

Obstructive Shock

Answer 21

• Due to mechanical obstruction of blood flow
  CO = decreased
  SVR = increased
  CVP = variable

Question 22

CVP

Answer 22

Central venous pressure

Question 23

What are the physical signs of Shock?

Answer 23

Hypotension, Tachycardia, Tachypnea

Cyanotic, oliguria and altered mental status

Question 24

What are the physical signs of Shock?

Answer 24

Hypotension, Tachycardia, Tachypnea

Cyanotic, oliguria and altered mental status

Question 25

What are the metabolic signs of Shock?

Answer 25

Elevated serum lactate

Metabolic acidosis

Question 26

What is the treatment of Shock?

Answer 26

ABC - Airway, Breathing, CIRCULATION
= Restore tissue perfusion and treat underlying cause
ex. IVF, vasopressors

Question 27

What are the special populations that may present differently with Shock?

Answer 27

Kids

Elderly