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Gen Pathology > Shock > Flashcards

Shock Flashcards

1
Q

THREE STAGES OF SHOCK

A

1Non Progressive State
2Progressive State
3Refractory State

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2
Q

____ state compensatory mechanism is still present but late stage, ____ state palliative care is the only treatment & ____ state px cant do anything to reverse effect of shock, the px will later on die (epi = inc heart rate, vasopressor = constrict blood vessels)

A

(1) Non progressive
(2) Progressive
(3) Refractory

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3
Q

shock due to surrounding environment

A

Obstructive Shock

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4
Q

low CO _____; low BV______

A

(1) Cardiogenic Shock (2) Hypovolemic Shock

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5
Q

infective agent: _____; hypersensitivity px, allergen _____ & defect in CNS _____

A

(1) Septic Shock
(2) Anaphylactic Shock
(3) Neurogenic Shock

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6
Q

indiv suffering from too much blood loss,
bluish lips or nail bed

A

Cyanosis

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7
Q

nervous tissue that detect low bp,
send signals to brain (medulla) to sympathetic nervous pathway (spinal cord)

A

Carotid or Aortic Sinuses

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8
Q

Ways to Dec Volume of Blood

A

(1) Loosing too much blood
(2) Loosing too much fluid

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9
Q

HEMORRHAGIC LOSS: HGTAPE

A

1 Hemoptysis
2 Gastrointestinal bleeding
3 Trauma
4 Abdominal Aorta
Aneurysm (rupture)
5 Post partum hemorrhage
6 Ectopic pregnancy - PID

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10
Q

NON-HEMORRHAGIC LOSS: 3DVAB

A

1 3rd degree burns
2 Diabetic keto acidosis
(glucose exceed transport
maximum by the kidneys -
glucose + water is excreted out
w urine)
3 Vomiting & diarrhea
4 Acute pancreatitis (over
active pancreatic enzymes)
5 Bowel obstruction

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11
Q

actual blood volume of RBC in blood

A

Hematocrit

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12
Q

____ Low RBC (Hemorrhagis loss); ______: High rbc (hypovolemic shock due to fluid loss)

A

(1) Low Hematocrit
(2) High Hematocrit

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13
Q

TREATMENT FOR HYPOVOLEMIC SHOCK (OBFA)

A

1) Give oxygen
2) Blood Loss- give blood transfusion
3) Fluid Loss give IV fluids or inc plasma colloid osmotic pressure (IV: Crystalloids: 0.9% Saline solution, Ringer’s solution)
4) Give Albumin - inc osmotic pressure, that will pull the fluid out of the tissue back to the circulation

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14
Q

Give IV fluids specifically

A

(IV: Crystalloids: 0.9% Saline solution, Ringer’s solution)

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15
Q

due to low cardiac output, inability of heart to function properly, there is nothing wrong w heart but it cant generate enough SV = low CO

A

Cardiogenic Shock

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16
Q

Conditions that can dec pumping activity of heart: CALVC

A

(1) Cardiomyopathy
(2) Arrhythmia
(3) Low CO
(4) Vascular Disease
(5) Congenital Heart Disease

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17
Q

enlargement of the heart w thin ventricular walls & cannot generate enough force to push blood out the heart

A

CARDIOMYOPATHY

18
Q

Vascular Disease: valves become too fibrotic, very firm, non-compliant, only a small vol of blood
can pass through

A

Stenosis of Mitral or Aortic Valve

19
Q

Vascular disease: opens when LA contracts, but due to fibrotic condition of mitral valve therefor they are only small num of blood that can be pushed by the LV

A

Mitral Valve Stenosis

20
Q

Low CO causes: ____infection in the heart muscle wall; ____ multiple ischemic stroke

A

(1) Myocarditis (2) Multiple MI

21
Q

TREATMENT FOR CARDIOGENIC SHOCK (MGAT)

A

(1) Medication: 1Antiviral | 2Antibacterial | 3Antiparasitic | 4Antifungal
(2) Give oxygen
(3) Angioplasty (due to plaque)
(4) Thrombolytics (due to thrombi - clot CA

22
Q

breakdown thrombi _____l makes blood viscous or anticoagulant ____

A

(1) thrombolytics (2) heparin

23
Q

Ways to Dec Volume of Blood in Obstructive Shock PACAT

A

(1) Pulmonary Emboli
(2) Aortic Emboli
(3) Cardiac Tamponade
(4) Aortic DIssection
(5) Tension Pneumothorax

24
Q

(1) Pulmonary Emboli
(2) Aortic Emboli
(3) Cardiac Tamponade
(4) Aortic DIssection
(5) Tension Pneumothorax

If emboli forms in the main branches of aorta = lessens blood vol circulating in the body = low CO (esp if emboli formed in the branch of aorta or ascending aorta)

A

(2) Aortic Emboli

25
Q

(1) Pulmonary Emboli
(2) Aortic Emboli
(3) Cardiac Tamponade
(4) Aortic DIssection
(5) Tension Pneumothorax

more common, right ventricle cannot push blood to pulmonary artery due to emboli blocking a branch of pulmonary artery

A

(4) Aortic DIssection

26
Q

(1) Pulmonary Emboli
(2) Aortic Emboli
(3) Cardiac Tamponade
(4) Aortic DIssection
(5) Tension Pneumothorax

accumulation of fluid in pericardial sac = compress heart = dec CO

Cardio synthesis: insert needle to pericardial cavity to extract excess fluid (treatment)

A

(3) Cardiac Tamponade

27
Q

(1) Pulmonary Emboli
(2) Aortic Emboli
(3) Cardiac Tamponade
(4) Aortic DIssection
(5) Tension Pneumothorax

air present in interpleural cavity that will drastically change pressure (can equalize to pulmonary pressure or +1 or +2)

insert a needle at affected side of the lung to drain excess air out

A

(5) Tension Pneumothorax

28
Q

Two Pressures in the Lungs or Air Sacs
_____ & ___ mmHG inside the lungs; _____ & __ mmHg in pleural space

A

(1) Pulmonary pressure (+) 0 mmHg
(2) Interpleural pressure (-) -3 or -4 mmHg

29
Q

Inflammatory mediators (HPBL)

A

(1) Histamine (2) Prostaglandin (3) Bradykinins (4) Leukotrienes

30
Q

Condition of px in Septic Shock

A

1HIV
2Pneumonia,
3COVID 19 (SARS COV 2 causative agent)

31
Q

stimulate the liver to produce certain proteins that would indicate that inflammation occurs

A

Cytokines

32
Q

inc number of virus in the body & activated macrophages
= secrete tons of cytokines in blood stream

A

Cytokine Storm (Peripheral Vasodilation)

33
Q

Affected Organ in Cytokine Storm

A

(1) Brain (2) Liver (3) Kidney

34
Q

Indicator for Cytokine Storm (1) (2)

A

(1) Heart very high lvl of tropnin in blood
(2) Liver very high liver enzymes

35
Q

basic principle of this shock is when foreign body enters, macrophages occur phagocytosis

A

Anaphylactic Shock

36
Q

protein produced while antigen breaks down by macrophages,
catches & binds on the fragments via exocytosis & stay on surface of the cell (macrophage) & present that fragment outside the surface

A

MHC: Major Histocompability Complexes

37
Q

macrophage has multiple MHC & fragment of antigen

A

APC Antigen Presenting Cell

38
Q

___ macrophage & dendritic cells are transformed to APC
Significance high affinity to CD4 (found in surface of helper T cells), enhances binding of APC

A

MHC Type 2

39
Q

found in other nucleated cells in body

A

MHC Type 1

40
Q

Treatment for Neurogenic Shock

A

give norepinephrine = to stimulate heart, give vasopressors for constrict blood vessels

41
Q

90% of parasympathetic nervous stimulation, nuclei is found on medulla

A

Vagus Nerve

Gen Pathology (5 decks)

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