Shock

Question 1

Define shock

Answer 1

Life threatening, circulatory failure, hypoxia, multiorgan failure

Question 2

Clinical signs of shock

Answer 2

tachycardia
poor urine output
confusion/reduced GCS
cold- delayed capillary refill, mottled appearance

Question 3

Two tests that are abnormal in shock

Answer 3

deranged LFTs
raised lactate

Question 4

Equation for blood pressure?

Answer 4

CO X systemic vascular resistance

Question 5

Equation for CO?

Answer 5

SV x HR

Question 6

How to assess systemic arterial resistance?

Answer 6

peripheral pulses
delayed capillary refill times
sats probe not picking up reading due to poor perfusion

Question 7

List three types of shock

Answer 7

obstructive
distributive
anaphylactic
cardiogenic

Question 8

What is distributive shock?

Answer 8

severe peripheral vasodilation problem

Question 9

List three causes of distributive shock

Answer 9

septic shock
neurogenic shock
endocrine
drug or toxin-induced shock

Question 10

What is SIRS?

Answer 10

=systemic inflammatory response syndrome
inflammatory response in reaction to severe body insult

Question 11

List two causes of SIRS

Answer 11

pancreatitis, burns, air/fluid/fat embolism
ROSC?= return of spontaneous cardiac output

Question 12

list three haemorrhageic causes of hypovolaemic shock

Answer 12

UGIB/LGIB
Post-op
postpartum, vaginal haemorrhage
AAA
Ruptured tumour, abscess, fistulae,
Trauma- blunt or penetrating

Question 13

List two non haemorrhagic causes of hypovolaemic shock

Answer 13

GI losses
burns
renal
third spacing- leaky capillaries e.g. infection, ascites, pancreatitis

Question 14

List two types of cardiogenic shock= poor pump function

Answer 14

ischaemia
arrhythmia
mechanical- valvular defects e.g. aortic stenosis

Question 15

List one type of RV after load obsturctive shock

Answer 15

PE
pulmonary HTN

Question 16

List one type of RV preload obstructive shock

Answer 16

tension pneumothorax
pericardial tamponade

Question 17

Difference between PE and massive PE?

Answer 17

massive PE- BP <90 systolic, therefore stable vs unstable

Question 18

Blood tests for PE?

Answer 18

D Dimer
Troponin- right heart strain

Question 19

Investigations for PE

Answer 19

CTPA

Question 20

What type of shock is anaphylaxis?

Answer 20

distributive

Question 21

Management of anaphylaxis

Answer 21

adrenaline
((corticosteroids
antihistamines
oxygen))
adrenaline infusion if repeated doses of adrenaline doesn’t work

Question 22

List two respiratory signs in anaphylaxis

Answer 22

tachyopnoeic
wheeze
stridor

Question 23

bloods in UGI?

Answer 23

U+E’s
FBC

Question 24

Target Hb for UGI bleed?

Answer 24

80

Question 25

Initial management of UGI caused by varices

Answer 25

terlipressin wide bore IV access, packed RBCs

Question 26

Patient with variceal bleeding is unstable, where should they go after ED?

Answer 26

endoscopy or surgeons

Question 27

Blood transfusion reactions?

Answer 27

tachycardia change in temperature urticarial rash