Shock

Question 1

Hypovolemic shock

Answer 1

Decreased cellular perfusion secondary to lack of circulating volume, or not enough gas (blood/plasma)

Question 2

Cardiogenic shock

Answer 2

Decreased cellular perfusion secondary to failure of the central pump, like a bad fuel pump (heart)

Question 3

Distributive shock

Answer 3

Decreased cellular perfusion secondary to maldistribution of oxygen to the periphery
Its like adding a much larger engine without increasing the size of the gas tank

Question 4

Obstructive shock

Answer 4

Decreased cellular perfusion secondary to obstruction of blood into or out of the ventricles (pulmonary embolism, pericardial tamponade, tension pneumothorax)
This is like getting dirt or blockage in the fuel line

Question 5

Shock

Answer 5

Is a state of impaired tissue perfusion resulting from circulatory failure brought on by a variety of causes

Question 6

Cellular cascade

Answer 6

Begins with cellular injury, cellular inflammation, and ultimately cellular death

Question 7

Cause of lactic acid production

Answer 7

The lack of oxygenated blood at the cellular level causes anaerobic metabolism

Question 8

Microvascular thrombosis and disseminated intravascular coagulation

Answer 8

Prolonged lactic acidosis leads to

Question 9

Compensated shock

Answer 9

Stage 1 or non-progressive
Compensatory mechanisms initiated
Vital organs perfused
Full recovery

Question 10

Uncompensated

Answer 10

Stage 2 or progressive
Compensatory mechanisms inadequate
Vital organs hypo-perfused
Recovery more difficult

Question 11

Irreversible

Answer 11

Stage 3
Compensatory mechanisms failed
Cellular or organ death
Refractory to treatment

Question 12

Angiotensin 2

Answer 12

Secretion of aldosterone
Vasoconstriction
Stimulation of antidiuretic hormone (ADH) secretion
Release of adrenaline, noradrenaline, and Aldosterone in the adrenal gland

Question 13

Aldosterone

Answer 13

Sodium and water reabsorption by the renal system
Increase excretion of potassium
Constriction of small arteries (arterioles)

Question 14

Adrenaline and noradrenaline

Answer 14

Vasoconstriction

Question 15

Altered capillary permeability

Answer 15

Leakage into the interstitial space
Edema
decreased blood pressure
decreased perfusion

Question 16

Respiratory insufficiency

Answer 16

Pulmonary edema
V/Q mismatch 
crackles 
dyspnea
increased respiratory rate

Question 17

Cardiac depression

Answer 17

Diminished venous return
ischemia of non-vital organs 
decreased blood pressure 
increased heart rate 
decreased CO 
decreased peripheral pulses
Dysrhythmias

Question 18

Tissue hypo perfusion

Answer 18

Severe vasoconstriction
ischemia of non-vital organs 
decreased urine output
increased lactate 
base deficit
mixed venous saturation (below 65%)
cool skin 
decreased peripheral pulses

Question 19

Brain hypoperfusion

Answer 19

Altered mental status

Question 20

Traumatic hemorrhage

Answer 20

Long bone or pelvic fracture
Solid organ rupture
Open wounds

Question 21

Non traumatic hemorrhage

Answer 21

GI bleed
Ruptured aortic aneurysm
Posterior epistaxis

Question 22

Fluid shifts

Answer 22

Peritonitis
Massive crush injuries
Severe burns

Question 23

Non blood fluid losses

Answer 23

Severe vomiting and diarrhea

Excessive diaphoresis

Question 24

Urinary fluid losses

Answer 24

Diabetic ketoacidosis
Diabetes insipidus
Diuretic abuse

Question 25

MAP

Answer 25

Systolic pressure + 2(diastolic pressure)/3

Question 26

NEVER

Answer 26

Dextrose ______ used in fluid resuscitation

Question 27

Packed RBC

Answer 27

Best product to rapidly elevate oxygen carrying capacity
must be ABO compatible
o-negative blood standard for not type specific resuscitation
O-positive blood may be given to men and women beyond childbearing age