Shock +

Question 1

components of stroke volume

Answer 1

Preload, Myocardial contractility, Afterload

Question 2

Venous capacitance, Volume status, Venous flow

• Preload
• Myocardial contractility
• Afterload

Answer 2

• Preload

Question 3

Mean venous systemic pressure- right atrial pressure

• Preload
• Myocardial contractility
• Afterload

Answer 3

• Preload

Question 4

Peripheral vascular resistance

• Preload
• Myocardial contractility
• Afterload

Answer 4

• Afterload

Question 5

in shock blood flow is preserved to

Answer 5

kidneys, heart and brain

Question 6

progression of vasoconstriction in shock

Answer 6

Progressive vasoconstriction of cutaneous, muscular and visceral circulation

Question 7

Poorly oxygenated cells will shift to anaerobic metabolism, hence formation of

Answer 7

lactic acid leading to metabolic acidosis

Question 8

most common type of shock

Answer 8

HEMORRHAGIC SHOCK

Question 9

suspect blunt cardiac injury in rapid deceleration

a. Cardiogenic
b. Cardiac tamponade
c. Tension pneumothorax
d. Neurogenic shock
e. Septic shock

Answer 9

a. Cardiogenic

Question 10

tachycardia, Becks triad, insufficient response to fluid

a. Cardiogenic
b. Cardiac tamponade
c. Tension pneumothorax
d. Neurogenic shock
e. Septic shock

Answer 10

b. Cardiac tamponade

Question 11

acute respiratory distress, subcutaneous emphysema, absent unilateral breath sounds, hyperesonance in percussion and tracheal shift

a. Cardiogenic
b. Cardiac tamponade
c. Tension pneumothorax
d. Neurogenic shock
e. Septic shock

Answer 11

c. Tension pneumothorax

Question 12

brainstem injuries; hypotension without tachycardia and cutaneous vasoconstriction

a. Cardiogenic
b. Cardiac tamponade
c. Tension pneumothorax
d. Neurogenic shock
e. Septic shock

Answer 12

d. Neurogenic shock

Question 13

can occur in patient’s arrival to ED is delayed for several hours

a. Cardiogenic
b. Cardiac tamponade
c. Tension pneumothorax
d. Neurogenic shock
e. Septic shock

Answer 13

e. Septic shock

Question 14

normal adult blood volume is what percent of body weight?

Answer 14

7% of body weight

Question 15

normal pediatric blood volume is what percent of body weight?

Answer 15

8-9% of body weight

Question 16

Equation for male EBW

Answer 16

50 kg + 2.3 kg for every inch over 5 feet

Male: 50 kg + 2.3 kg for every inch over 5 feet
Female: 45.5 kg + 2.3 kg for every inch over 5 feet
1-11 months: (0.5 x age in months) + 4
1-5 years: (2 x age in years) + 8
6-12 years: (3 x age in years) + 7

Question 17

Equation for female EBW

Answer 17

45.5 kg + 2.3 kg for every inch over 5 feet

Male: 50 kg + 2.3 kg for every inch over 5 feet
Female: 45.5 kg + 2.3 kg for every inch over 5 feet
1-11 months: (0.5 x age in months) + 4
1-5 years: (2 x age in years) + 8
6-12 years: (3 x age in years) + 7

Question 18

Equation for 1-11 months EBW

Answer 18

(0.5 x age in months) + 4

Male: 50 kg + 2.3 kg for every inch over 5 feet
Female: 45.5 kg + 2.3 kg for every inch over 5 feet
1-11 months: (0.5 x age in months) + 4
1-5 years: (2 x age in years) + 8
6-12 years: (3 x age in years) + 7

Question 19

Equation for 1-5 years EBW

Answer 19

(2 x age in years) + 8

Male: 50 kg + 2.3 kg for every inch over 5 feet
Female: 45.5 kg + 2.3 kg for every inch over 5 feet
1-11 months: (0.5 x age in months) + 4
1-5 years: (2 x age in years) + 8
6-12 years: (3 x age in years) + 7

Question 20

Equation for 6-12 years EBW

Answer 20

: (3 x age in years) + 7

Male: 50 kg + 2.3 kg for every inch over 5 feet
Female: 45.5 kg + 2.3 kg for every inch over 5 feet
1-11 months: (0.5 x age in months) + 4
1-5 years: (2 x age in years) + 8
6-12 years: (3 x age in years) + 7

Question 21

(< 15%)

Class I Hemorrhage
Class II
Class III
Class IV

Answer 21

Class I Hemorrhage

Question 22

the condition of an individual who has donated 1 unit of blood

Class I Hemorrhage
Class II
Class III
Class IV

Answer 22

Class I Hemorrhage

Question 23

(15- 30%)

Class I Hemorrhage
Class II
Class III
Class IV

Answer 23

Class II

Question 24

Uncomplicated hemorrhage for which crystalloid fluid resuscitation is required

Class I Hemorrhage
Class II
Class III
Class IV

Answer 24

Class II

Question 25

Tachycardia, tachypnea and decreased pulse pressure Class I Hemorrhage Class II Class III Class IV

Answer 25

Class II

Question 26

Subtle CNS changes: anxiety, fear, hostility Class I Hemorrhage Class II Class III Class IV

Answer 26

Class II

Question 27

(31 to 40%) Class I Hemorrhage Class II Class III Class IV

Answer 27

Class III

Question 28

which at least crystalloid infusion is required and most will blood products to reverse shock state Class I Hemorrhage Class II Class III Class IV

Answer 28

Class III

Question 29

marked tachycardia and tachypnea and measurable fall in systolic blood pressure Class I Hemorrhage Class II Class III Class IV

Answer 29

Class III

Question 30

significant changes in mental status Class I Hemorrhage Class II Class III Class IV

Answer 30

Class III

Question 31

what is classic sign of inadequate perfusion:

Answer 31

marked tachycardia and tachypnea, significant changes in mental status and measurable fall in systolic blood pressure

Question 32

(> 40%) Class I Hemorrhage Class II Class III Class IV

Answer 32

Class IV

Question 33

Blood transfusion is required Class I Hemorrhage Class II Class III Class IV

Answer 33

Class IV

Question 34

very narrow pulse pressure Class I Hemorrhage Class II Class III Class IV

Answer 34

Class IV

Question 35

Which is the most severe? Class I Hemorrhage Class II Class III Class IV

Answer 35

Class IV

Question 36

The most effective method of restoring CO, end-organ perfusion and tissue oxygenation is restoring VR to normal by

Answer 36

locating and stopping source the source of bleeding

Question 37

Most desirable sites for vascular access

Answer 37

forearms and antecubital veins

Question 38

initial warmed fluid bolus for adult

Answer 38

is 1 liter

Question 39

initial warmed fluid bolus for pediatric patients weighing less than 40 kg

Answer 39

20 ml/kg

Question 40

Early administration of blood products must be considered Class I Hemorrhage Class II Class III Class IV

Answer 40

Class III | Class IV

Question 41

adequate volume replacement for adult

Answer 41

0.5 ml/kg/hr (adult)

Question 42

adequate volume replacement for pedia

Answer 42

1 ml/kg/hr (pedia)

Question 43

adequate volume replacement for infant

Answer 43

2ml/ kg/ hr (under 1)

Question 44

If crossmatched blood is unavailable, what is indicated for exsanguinating hemorrhage?

Answer 44

type O PRBC

Question 45

What blood replacement is preferred for female of childbearing age?

Answer 45

Rh- negative PRBC

Question 46

Define massive transfusion

Answer 46

as > 10 units of PRBC within the first 24 hours of admission or more than 4 units in 1 hour

Question 47

what can be given in the first 3 hours of hemorrhagic shock to improve survival what is dose?

Answer 47

Tranexamic Acid First dose: 1gram over 10 minutes Follow-up dose: 1 gram over 8 hours