Shock

Question 0

clinical features of shock (4)

Answer 0

tachycardia
tachypnea
possibly hypotension
signs of poor end-organ perfusion: AMS, oliguria, lactic acidosis, cool extremities, weak/thready pulse

Question 1

normal AVO2 difference

Answer 1

< 25-30

Question 2

causes of non-hemorrhagic hypovolemic shock (5)

Answer 2

GI losses
dehydration
burns
3rd space losses (inflammation)
neuro/renal (DI, DM)

Question 3

causes of hemorrhagic hypovolemic shock (3)

Answer 3

bleeding (internal/external)
operative
iatrogenic (open A-line, C-line)

Question 4

compensated shock sends blood to (4)

Answer 4

brain
heart
kidneys
liver

Question 5

compensated shock directs blood away from (3)

Answer 5

skin
GI tract
skeletal muscle

Question 6

management of hypovolemic shock due to bleeding

Answer 6

apply pressure to wound, elevate above heart

Question 7

obstruction shock is?

3 causes?

Answer 7

mechanical block to heart’s outflow

PE
cardiac tamponade
tension pneumo

Question 8

cardiogenic shock?

causes?

Answer 8

failure of the heart to pump effectively

damage to the heart muscle, MI, arrhythmias, cardiomyopathy, CHF, valve problems

Question 9

management of cardiogenic shock? (3)

Answer 9

inotrope
vasodilator if BP ok
constrictor if hypotensive

Question 10

management of septic shock

Answer 10

volume, then vasoconstrictor

Question 11

management of hypovolemic shock

Answer 11

volume, temporary vasoconstrictor until vol. restored

Question 12

types of distributive shock? (3)

Answer 12

septic shock
anaphylactic shock
neurogenic shock

Question 13

neurogenic shock results (3)

Answer 13

decreased PVR
increased vasodilation
hypotension

Question 14

what is distributive shock?

Answer 14

insufficient intravascular blood volume
relative hypovolemia
result of dilation of all blood vessels

Question 15

exaggerated endogenous inflammatory response

Answer 15

septic shock

Question 16

diagnosis of SIRS?

Answer 16

Two or more:
temp >38 or 90 beats/min
RR > 20 or PaCO2 < 32 mmHg
WBC > 12,000 or < 4,000 or > 10% bands

Question 17

whats the difference between warm and cold shock (2)

Answer 17

hyperdynamic/hypodynamic

flushed moist skin vs pale dry skin

Question 18

best ionotrope only?

Answer 18

Milrinone

Question 19

epinephrine functions?

Answer 19

potent ionotrope and vasoconstrictor

Question 20

dopamine vs dobutamine

Answer 20

dopamine has dose-dependent vasodilation