Shock

Question 1

What is shock?

Answer 1

Clinical syndrome of tissue hypoperfusion

Question 2

How is mean arterial pressure calculated?

Answer 2

1/3 difference between systolic and diastolic

Question 3

What effects does hypoperfusion having on acidosis/alkalosis?

Answer 3

Causes systemic acidosis (pH<7.35) further worsening global enzyme function and cellular performance

Question 4

What effect does hypoperfusion have on micro circulation?

Answer 4

Capillary blood flow is reduced

Question 5

Sign of tissue hypoperfusion?

Answer 5

Mottling
GCS<15
Urine output < 0.5ml/kg/hr
High lactate

Question 6

Pathophys of cardiogenic shock?

Answer 6

Reduced force of cardiac contraction and stroke volume–> decreased CO and MAP

Compensatory increase in SVR, resulting in cool clammy peripheries

Question 7

Pathophys of obstructive shock?

Answer 7

Obstruction to cardiac outflow

Evidence of raised JVP and distended neck veins may be prominent

Question 8

Examples of cause of obstructive shock?

Answer 8

Cardiac tamponade

Pneumothorax w/ mediastinal shift

Question 9

Pathophys of hypovolaemic shock?

Answer 9

Reduced blood volume
Lower venous return to heart (end diastolic volume)
Reduced force of cardiac contraction and CO (FS Law)

Question 10

Pathophys of distributive shock?

Answer 10

Reduced systematic vasc resistance due to vasodilation
Reduced MAP
Compensatory increase in CO