shock

Question 1

what is shock

Answer 1

Failure to maintain adequate tissue perfusion

Question 2

what does shock lead to

Answer 2

inadequate tissue perfusion = cellular dysfunction = decrease oxygen =
1. Anaerobic respiration = increase lactic acid = acidosis
2. decrease ATP = Na+/K+ pump failure = disrupts membrane potential = neurological dysfunction

• decrease nutrient
  = Increase lipolysis
  = hyperlipidemia and increase ketones
  = keto acidosis

also causes increase gluconeogenesis
= protein catabolism =
1. decrease serum proteins = decrease capillary osmotic pressure = increase capillary permeability = hypovolemia
2. azotemia

Question 3

cardiogenic shock pathway

Answer 3

Problem with heart = drop in cardiac output = decrease tissue perfusion (hypoxia, tissue damage) =
- activation of SNS and RAAS
= excess cardiac workload that can’t be accommodated
= decrease C.O

Question 4

obstructive shock pathway

Answer 4

Decrease or No blood flow through greater vessels
= decrease C.O
e.g. pulmonary embolism, pulmonary hypertensions

Question 5

Hypovolemic + causes

Answer 5

Decrease volume (loss of 15% or more)
= decrease tissue perfusion
e.g. hemorrhage, dehydration, burns, diuresis,

Question 6

phases of hypovolemic shock

Answer 6

Phase 1.
Decrease vitals

Phase 2.
Activation of SNS and RAAS = increase vital signs

Phase 3.
Failure of SNS and RAAS

Phase 4.
Systemic failure

Question 7

three types of distributive shock

Answer 7

1. Neurogenic shock
   Increase PSNS and decrease SNS
   = widespread vasodilation = decrease TPR = decrease BP = decrease tissue perfusion
   e.g spinal cord injury, brainstem injury
2. anaphylactic shock
   Allergens stimulate hypersensitivity reaction
   = widespread vasodilation (driven by numeral immune response)
3. Septic shock
   Sepsis (blood infection)
   = inflammatory immune response
   = widespread vasodilation

Question 8

three types of distributive shock

Answer 8

1. Neurogenic shock
2. anaphylactic shock
3. Septic shock

Question 9

neurogenic shock pathway

Answer 9

Increase PSNS and decrease SNS
= widespread vasodilation = decrease TPR = decrease BP = decrease tissue perfusion
e.g spinal cord injury, brainstem injury

Question 10

anaphylactic shock pathway

Answer 10

Allergens stimulate hypersensitivity reaction
= widespread vasodilation (driven by numeral immune response)

Question 11

septic shock pathway

Answer 11

Sepsis (blood infection)
= inflammatory immune response
= widespread vasodilation