Shock

Question 1

what is the frank starling law of the heart?

Answer 1

SV increases in response to inc volume of blood in the ventricles

Question 2

bleeding from everywhere….

Answer 2

DIC

Question 3

normal MABP

Answer 3

70-100mmHg

Question 4

how to calculate MABP

Answer 4

1/3 systolic + 2/3 diastolic

Question 5

metabolic signs of shock?

Answer 5

acidosis

high lactate

Question 6

urine output of what should make you think shock?

Answer 6

<0.5ml/kg/h

Question 7

skin appearance of shock?

Answer 7

mottled

clammy

Question 8

lactate >_ of normal is a sign of shock

Answer 8

1

Question 9

normal lactate?

Answer 9

0.5-1

Question 10

why do you get cool, clammy peripheries in cardiogenic shock?

Answer 10

SVR increases to get blood back to the heart so less in the peripheries

Question 11

cause of cardiogenic shock

Answer 11

arrhythmia
poisoning
MI
cardiomyopathy
valve failure

Question 12

what would you expect to be raised in obstructive shock and why?

Answer 12

JVP

obstructed cardiac outflow causes back up into the RHS circulation

Question 13

causes of obstructive shock

Answer 13

cardiac tamponade
tension pneumo
PE

Question 14

causes of cardiac tamponade

Answer 14

aortic dissection

trauma

Question 15

Tx PE

Answer 15

anticoagulation

thrombolysis

Question 16

end diastolic volume measures…

Answer 16

the filling of the ventricles

Question 17

why does RR go up in shock

Answer 17

trying to get rid of acidosis by blowing off CO2

Question 18

describe the peripheries in distributive shock? why?

Answer 18

warm, red peripheries

vessels are abnormally vasodilated

Question 19

non GI causes of dehydration?

Answer 19

epithelial loss by burns

renal/cellular loss eg DKA, addisonian crisis

Question 20

causes of distrubutive shock

Answer 20

inflammatory eg sepsis/SIRS from pancreatitis/anaphylaxis

Question 21

Tx distrubutive shock

Answer 21

antibiotics
vasopressors eg adrenaline
supportive

Question 22

Tx neurogenic shock

Answer 22

neurosurgery

vasopressors

Question 23

alpha stimulation causes…

Answer 23

vasoconstriction

Question 24

beta stimulation causes…

Answer 24

inotropic stimulation

Question 25

why do you get SoB in a type 1 hypersensitivity reaction?

Answer 25

constriction of bronchial SM by histamine causes wheeze

Question 26

what does histamine do to the heart?

Answer 26

increases contractility and inotropic effects by Ca influx

Question 27

4 pharmacological steps for a patient with an allergic transfusion reaction?

Answer 27

1. adrenaline IV
2. chlorampherimine
3. salbutamol
4. IV steroids

Question 28

what does chloramphenamine do?

Answer 28

blocks histamine and stops it exerting effects

Question 29

why are corticosteroids useful in anaphylaxis?

Answer 29

block leukotrienes

Question 30

ABO incompatibility is a type _ hypersensitivity reaction?

Answer 30

2

Question 31

what causes haematuria in ABO incompatibility

Answer 31

patient IgM binds to antibodies on the donor red cells
complement activate
membrane attack complex triggered
red cell lysis by intravascular haemolysis

Question 32

cytokine release causes an inc/dec in temp

Answer 32

inc

Question 33

what kind of jaundice is caused by intravascular haemolysis

Answer 33

prehepatic

Question 34

there is an increase in ____ pressure in fluid overload

Answer 34

hydrostatic

Question 35

what blood treatment commonly causes transfusion associated lung injury?

Answer 35

plasma rich products eg FFP and platelets