Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Mechanisms of Disease > Shock > Flashcards

Shock Flashcards

1
Q

What is “third spacing”?

A

Fluid (not blood) escapes from blood into extravascular space.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is hypovolemia manifested? (4 things)

A

Tachycardia (bradycardia in cats)
Prolonged CRT
Poor peripheral pulses
Decreased urine output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are 3 causes of hypovolemia?

A

Blood loss
Severe dehydration
Redistribution of fluids in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What causes circulatory shock?

A

Intravascular compromise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does hypovolemic shock result in?

A

Inability of the body to perform circulatory functions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 3 failures of the CV system?

A

Failure of the pump
Failure of the tubing
Failure of the fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Failure of the pump = ?

A

Cardiogenic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Failure of the tubing = ?

A

Distributive shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Failure of the fluid = ?

A

Hypovolemic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 5 classifications of circulatory shock?

A 
Hypovolemic
Cardiogenic
Vasodilatory or distributive
Obstructive
Combination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are 3 types of fluid loss?

A

Hemorrhagic
Non-hemorrhagic
Redistribution (edema)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which type of circulatory shock is most commonly associated with sepsis?

A

Vasodilatory or distributive shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When do you see obstructive shock? (4 things)

A

GDV
Pericardial effusion
Venous thrombosis
Tension pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are 3 things that cause cardiogenic shock?

A

Severe acquired heart disease
Severe congenital heart disease
Anesthetic overdose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where is the obstruction usually in obstructive shock?

A

In the venous return

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do you fix obstructive shock?

A

Remove the obstruction and use IV fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What causes vasodilatory/distributive shock?

A

Inflammatory mediators associated with SIRS (systemic inflammatory response syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the major causes of vasodilatory.distributive shock? (6 things)

A 
Sepsis
Endotoxemia
Massive muscle trauma
Emboli
Thrombi
Anaphylaxis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is sepsis?

A

Systemic infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is severe sepsis?

A

Sepsis + dysfunction of one or more organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is septic shock?

A

Body reacts via immune and inflammatory responses when cell wall of G- bacteria is destroyed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

T/F: G- bacteria don’t normally live in the gut.

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Can G+ bacteria cause sepsis?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the two phases of sepsis?

A

Hyperdynamic/warm

Hypodynamic/cold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the hyperdynamic phase of sepsis? (6 things)

A 
High cardiac output
low peripheral resistance
Leaky capillaries
Increased HR, RR, temp
Rapid CRT
Red MM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

T/F: Hyperdynamic phase is commonly seen in cats?

A

No, Hypodynamic phase is common in cats. Hyperdynamic phase is rarely seen in cats.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the goal in the hyperdynamic phase?

A

Body is trying to compensate and overcome the sepsis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the hypodynamic phase of sepsis? (5 things)

A 
Low cardiac output
Increased peripheral resistance
Decreased BP, HR, Central Venous Pressure
Weak pulse
Pale to cyanotic MM and prolonged CRT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What does the hypodynamic phase of sepsis become?

A

MODS (Multiple Organ Dysfunction Syndrome)

30
Q

Can different shocks overlap?

A

Yes

31
Q

What percentage of BW in dogs and large animals is blood?

A

8-9% (80-90mL/kg)

32
Q

What percentage of BW in cats is blood?

A

5-6% (50-60mL/kg)

*Note: for this class, use 45mL/kg

33
Q

T/F: It’s 50:50 RBCs:plasma

A

True

34
Q

What happens in the compensated stage of shock?

A

Blood volume decreases = decreased vessel filling = activation of stretch and barroreceptors = increased sympathetic stimulation and vasoconstriction

35
Q

What are the shock organs of dogs?

A

GI and Liver

36
Q

What are the shock organs of horses?

A

GI and Lung

37
Q

What are the shock organs of cats, ruminants and pigs?

A

Just the lungs

38
Q

What happens in the decompensated stage of shock?

A

Local tissues that were vasoconstricted begin to vasodilate causing blood to pool and maldistribution.

39
Q

What are the clinical signs of hypovolemic shock? (5 things)

A 
Tachycardia in dogs/Bradycardia in cats
Pale MM
Prolonged CRT
Cool limbs
Weak pulse (MAP <70mmHg)
40
Q

What are the clinical signs of cardiogenic shock?

A

Signs overlap with hypovolemia

Look for signs of heart failure (loud murmur, arrhythmia, history of heart disease)

41
Q

How do you treat hypovolemic, non-hemorrhaagic shock?

A

Rapid fluid replacement if no head or lung injury with a large bore, short IV catheter

42
Q

What fluids would you use with hypovolemic shock?

A

Crystalloids

43
Q

What hypovolemic patients would you give 0.9%NaCl?

A

Patients with projectile vomiting or metabolic alkalosis (because 0.9%NaCl is more acidic)

44
Q

What are the fluid rates for shock patients?

A

Dogs: 90mL/kg/hr
Cats: 45mL/kg/hr

45
Q

How do you administer fluids to a shock patient?

A 
First 1/4 of calculated dose ASAP
Reassess perfusion (HR, BP, CRT, urine output)
Adjust rate (give rest of dose over next hour OR give 1/4 shock dose boluses every 15 minutes followed by reassessment)
46
Q

Why do you give 1/4 bolus treatment to shock patient?

A

First 1/4 treats perfusion issue, the rest helps treat interstitial dehydration

47
Q

Do you give a shock dose if the dog is anemic?

A

Yes, if dog is in shock. If dog is obviously anemic, then hemorrhagic hypovolemic shock is present and a transfusion will be necessary.

48
Q

What fluid types would you use in a dog that is shocky and anemic?

A

Crystalloids for shock, and add in colloid to help restore oncotic pressure and prevent interstitial edema.

49
Q

Do you give a shock dose to a dog who has low albumin?

A

Yes, but use crystalloid for shock and add in coloid to restore oncotic pressure.

50
Q

What fluids would you use in a patient with head trauma?

A

Hypertonic saline

51
Q

How fast does hypertonic saline work?

A

Rapidly, but results are transient.

52
Q

What are contraindications to using hypertonic saline?

A

Dehydration and heart failure

53
Q

How do you treat hemorrhagic, hypovolemic shock?

A

Transfusion (whole blood or packed RBCs)

54
Q

Is blood typing recommended for blood transfusions?

A

Yes

55
Q

What is the canine universal blood donor?

A

DEA 1.1 neg

56
Q

How is septic shock treated?

A

Same fluid therapy as hypovolemic shock, and broad spectrum antibiotics.

57
Q

If you have septic shock and a peritonitis, what must also be done on top of fluid therapy?

A

Surgical exploration/drainage.

58
Q

When is continued IV fluid administration contraindicated?

A

Jug is distended
Crackles heard on auscultation
CVP > 10 cm H2O

59
Q

What do a distended jug, crackles on auscultation and CVP>10cm H2O mean?

A

Fluid overload

60
Q

What do you do if you have fluid overload?

A

Vasopressors

61
Q

What do you do if you have pericardial tamponade? (6 things)

A 
O2
Minimal fluids until cardiac function can be determined
Furosemide if CHF
Manage arrhythmias
Vasodilators
Positive inotropes
62
Q

What parameters do you monitor with any type of shock?

A 
Mentation
HR + pulse quality
RR + effort
Temp
Urine output
BP
63
Q

How much urine output should you expect?

A

1mL/kg/hr

64
Q

What should BP be at?

A

Greater than 80 mmHg

65
Q

What is SIRS?

A

Systemic Inflammatory Respones Syndrome, an imbalance between pro- and anti-inflammatory mediators

66
Q

When do you see SIRS?

A

When infection is not contained, whole body is affected

67
Q

What are some non-infections causes of SIRS?

A 
Hyportension
Traume + hemorrhage
Hypoxia + ischemia
Pancreatitis
Burns
Neoplasia
68
Q

What is the “second hit theory”?

A

First event (eg. HBC) primes immune system, Second even (loss of blood leading to hemorrhagic shock) results in excessive inflammatory response.

69
Q

What is MODS?

A

Multiple Organ Dysfunction System

70
Q

What is mortality of MODS?

A

50%+

Mechanisms of Disease (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions