Shock Flashcards

1
Q

What is clinical shock?

A

Acute circulatory failure leading to inadequate perfusion and cellular hypoxia

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2
Q

What are some clinical signs of shock? (5)

A

Tachycardia, tachypnoea, confusion, pallor, MAP<8kPa

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3
Q

What can cause low BP (shock)?

A

Low cardiac output or low systemic vascular resistance

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4
Q

What are some causes of reduced cardiac output? (2 categories)

A

Reduced preload: tension pneumothorax, PE, haemorrhage

Decreased contractility: CVD, hypoxia, drugs, pH or electrolyte disturbance

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5
Q

What are causes of low SVR?

A

Often pathogens. Bacterial toxins-> sepsis. Excess NO from macrophages

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6
Q

What is compensated shock?

A

Body control mechanisms are able to keep working

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7
Q

What is decompensated shock?

A

End organs not perfused and eventually fail.

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8
Q

What are the 4 kinds of shock?

A

Obstructive, distributive, hypovolaemic, cardiogenic

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9
Q

What are the signs of hypovolaemic shock?

A

Low BP, tachycardia, confusion, cold clammy skin, slow capillary refill, greyish pallor, oliguria, absent bowel sounds

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10
Q

What are the signs and symptoms of cardiogenic shock?

A

Chest pain, dyspnoea, diaphoresis, nausea, pulmonary oedema, tachycardia, very little urinary output

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11
Q

How do you treat cardiogenic/ hypovolaemic shock?

A

Expand circulating volume using CVP as a guide

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12
Q

What are the signs and symptoms of sepsis?

A

Low BP, tachy etc. FEVER, chills, rigors, fatigue, nausea, confusion

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13
Q

Signs and symptoms of obstructive shock?

A

Abrupt onset pleuritic pain, dyspnoea, hypoxia, tracheal deviation

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14
Q

Causes of obstructive shock?

A

PE or pneumothorax

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15
Q

Immediate compensatory responses to shock?

A

SNS up up, reduced urine and sodium excretion

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16
Q

Longer term compensatory responses to shock?

A

Inc renin from kidney, inc aldosterone from adrenal cortex. Thirst stimulated. Inc plasma proteins released from liver. EPO from peritubilar fibroblasts

17
Q

How does septic shock happen?

A

LPS in gram negative bacteria-> neutrophils and monocytokines-> inflammation-> micro vascular damage-> reduced SVR

18
Q

Management of shock? (4)

A

Lying down with head and heart level. Restore circulating BV. Standard vasopressor drugs. Appropriate antimicrobials.

19
Q

Therapeutic goals of managing songs?

A

CVS: 8-12mmHg
MAP: over 65mmHg
Urine output: 0.5mL/kg/h
SVC: over 70%