Shock

Question 1

The Phenomenon of Shock

Answer 1

characterized by an imbalance b/t O2 supply requirements at the cell level. This results in widespread impaired cell metabolism and may progress to irreversible organ damage and death.
When cell does not have adequate amounts of O2 and nutrients/glucose, it is unable to meet metabolic demands. Glucose is not able to be used bc of ischemia and bc cortisol is released due to stressful conditions. Cortisol causes body to preferentially send glucose to bran and thus leaves other cells deprived.

Question 2

Cardiogenic Shock

Answer 2

Results from heart failure of any kind. Causes CO to decrease. As CO decreases, renal and hypothalamic adaptic responses maintain or increase BV, TPR. Compensation keeps BP and CO ok at the cost of the myocardium. Body cells are not getting pumped the blood they need so they fail.
75-80% in hospital death rate. Deadliest form of shock

Question 3

Hypovolemic Shock

Answer 3

Associated with loss of BV, plasma or interstitial fluid,m such as through vomiting, diarrhea or burns. Begins to develop when overall blood volume is decreased by 15%. Initially offset by compensatory mechanisms. If fluid or blood loss is to great compensation will fail. The nutrient delivery is also impaired so cellular metabolism falls.
Clinical signs: high SVR, poor skin turgor, thirst, low systemic and pulmonary preloads, rapid HR, oliguria

Question 4

Distributive Shock: Anaphylactic, Nurogenic & Septic Shock

Answer 4

Each has certain features, but all are associated with impaired tissue oxygenation that can progress to refractory shock and organ failure. 
Neuroenic shock (Vasogenic shock) is widespread, massive vasodilation due to imbalance between para and symp stimulation of vascular smoothe muscle. It creates relative hypervolemia, so BV is not changed, the space is just increased.