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Animal Diseases > Shock > Flashcards

Shock Flashcards

1
Q

Define shock

A

State of organ hypoperfusion causing cellular damage and death due to lack of oxygen

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2
Q

True or false

Shock is a pathological state

A

True

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3
Q

True or false

Shock isn’t always an emergency

A

False

It is ALWAYS an emergency

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4
Q

What is the difference between emotional and pathological shock

A

Pathological shock is a physiological state of being

Emotional shock occurs after a distressing event

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5
Q

What are some basic causes of shock

A

Trauma
Dehydration
Blood loss
Lack of oxygen

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6
Q

What are the 3 major categories of the causes of shock

A

Hypovolemic shock

Cardiogenic shock

Distributive/vasogenic shock

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7
Q

What is hypovolemic shock

A

Most common

Occurs when there is a loss in blood/fluid volume which results in inadequate circulatory volume and hypotension which causes decreased perfusion

Or due to plasma volumes being lost through burns, dehydration, vomitting, diarrhea, or effusions

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8
Q

Define perfusion

A

The passing of fluid through vessels to a tissue or organ

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9
Q

Define effusion

A

The escape of fluid into a body cavity

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10
Q

What is hemorrhagic shock

A

Type of hypovolemic shock caused hy acute blood loss (trauma, surgery, bleeding disorders, DIC)

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11
Q

What is cardiogenic shock

A

When the heart is unable to pump there is a decreased cardiac output which causes hypotension and decreased perfusion

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12
Q

When does cardiogenic shock occur

A

With end stage congestive heart failure, arrythmias, myocardial infarcation, ventrical abnormalities, pericardial effusion, trauma

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13
Q

What is myocardial infarcation

A

Obstruction of the blood supply to the heart

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14
Q

What is vasogenic shock or distributive shock

A

Something causes the blood vessels to dilate which causes blood to pool in capillaries and decreases blood flow ti other organs or tissues

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15
Q

What are 4 of the many causes of vasogenic shock (and therefore vasodilation)

A

Anaphylactic shock

Endotoxic shock

Neurogenic shock

Septic shock

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16
Q

What is anaphylactic shock

A

A type of vasogenic shock caused by a secere allergic reaction that affects multiple organ systems

If enough histamine is released during reaction and enter circulation, it causes wide spread dilation of the capillaries

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17
Q

True or false

Vasodilation is always part of inflammation

A

True

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18
Q

How fast does anaphylactic shock occur

A

Minutes to hours

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19
Q

What is endotoxic shock

A

A type of vasogenic shock, it is systemic vasodilation that occurs due ti an underlying gram negative infection, the bacteria release large amounts of endotoxin (lipid A of lipopolysaccharides) which enters circulation and creates widespread inflammation/vasodilation

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20
Q

What is neurogenic shock

A

A type of vasogenic shock, occurs with trauma to the brain or soinal cord that disrupts the autonomic NS

21
Q

What happens in neurogenic shock due to lack of sympathetic innervation

A

Causes a lack of vascular resistance (vasoconstriction) in the capillaries (especially in the GIT and skin)

Can causes slowing down of the heart (cardiogenic component)

22
Q

What is septic shock

A

A type of vasogenic shock, caused by wide spread inflammation due to an underlying systemic bacterial infection (most common), fungus or virus. causing widespread inflammation

23
Q

When is septic shock seen

A

Perforated GI foreign bodies

Neonatal foal spesis

And severe infections

24
Q

What are some other causes of vasogenic/distributive shock not related to inflammation

A

Hyperthermia

Overdose with inhalant anesthetic

25
Q

In human medicine, what is obstructive shock

A

Shock due to an obstruction of blood flow

26
Q

True or false

You can be classified as having mutiple different types of shock at once

A

True

27
Q

Give an example of the type of shock a hit by car patient would have

A

Hypovolemic (bleeding)

Distributive (damage to brain spinal cord)

28
Q

Once shock has set in, what are the two levels of shock that occur

A

Compensatory shock

Non compensatory shock

29
Q

What is compensatory shock

A

This is the Early stage of shock, in this stage is when the systems not affected/causing the shock will increase fucntion to try and offset the failing parts

30
Q

If there is blood volume loss how does the body compensate

A

Increasing heart rate and constricting vessels

31
Q

If the heart fails, how does the body compensate

A

Blood vessels constrict and the body will retain water

32
Q

If the blood vessels dialte, how does the body compensate

A

The heart will be faster and try to retain water

33
Q

Increased heart rate and vasoconstriction is driven by the

A

Sympathetic nervous system

34
Q

Water retention and vasoconstriction are also driven by

A

The hormonal system based in the kidneys

35
Q

In early stages of shock, there may be a normal or mildly affected blood pressure, normal CRT, pink to pale pink MM, normal temp, with an increased ____

A

Heart rate and respiratory rate

36
Q

How long is the compensatory stage of shock

A

Very short

37
Q

If the underlying cause of shock is not treated during the early stages of shock what happens

A

Patient will go into non compensatory shock

38
Q

What is non compensatory shock

A

When the body cannot keep up or compensate enough to the causes of shock, at this point blood pressure will start/continue to drop

Blood flow shifts to vital organs and away from others causing ischemic damage which causes lactic acid production and acidosis, then myocardial disfunction and death

39
Q

What are the initial signs of non compensatory shock

A

Drop in blood pressure
Increased HR and RR
CRT >2
Light pink to pale MM

40
Q

What are the clinical signs of non-compensatory shock after it has advanced

A 
Drop in blood pressure
Decreased HR and RR
temp drops (can feel in extremities and mouth) 
Weak pulse
Coma/stupor 
Pale MM (cyanotic or muddy)
Long CRT
41
Q

Once acidosis develops in non compensatory shock due to decreased heart function, what occurs

A

Decreased blood flow and hypothermia this then leads to issues with clotting

There is rapid death at this point

42
Q

Why is compensatory shock difficult to diagnose

A

It has a normal BP with an increasing HR and RR (must determine whether its shock based on history)

Temp is normal (may be high with inflammation)

CRT is normalish

43
Q

What are the steps in treating shock

A

Place IV catheter and starte shock fluid rate
Stop bleeding
Give oxygen
Restore acid-base imbalances/correct electrolytes
Support organ function
Treat underlying problem

44
Q

What are the shock fluid rates

A

90ml/kg for dogs
50ml/kg for cats
80ml/kg for large animal

45
Q

What are the steps in giving shock fluid rates

A

Give the first 25% of the volume ASAP

assess vitals

If vitals are still low Give another 25%

If they are still low again, add a colloid

Go to regular fluid plan once they are stable

46
Q

How long does it take for each fluid portion to stabilize the patient

A

Approx 20 minutes

47
Q

What is the therapeutic objective in shock

A

To return blood pressure to normal to restore tissue perfusion

48
Q

How do you support organ function in shock

A

Intestinal protectants
Heart medication
Vasoconstrictors

49
Q

How may you treat underlying causes of shock

A 
Antibiotics
Surgery
Anti-inflammatories 
Transfusions 
Anti-arrhythmia drugs 
Antihistamines

Animal Diseases (15 decks)

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