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shock Flashcards

1
Q
  1. Factors involved in the mechanism of reperfusion injury:
    Select one or more:
    a. increased sympathetic tone
    b. tissue hypoxia
    c. endothelial cell damage
    d. activation of the renin-angiotensin-aldosteron system (RAAS
A

b

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2
Q 
2. typical for anaphylaxis:
Select one or more:
a. systemic reaction of sepsis
b. triggered by allergic reaction
c. allergen can be food
d. the consequence of vomiting or diarrhea or dehydration
A

b/c

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3
Q 
3. Causative factors of hyperdynamic stage in distributive shock:
Select one or more:
a. accumulation of lactic acid
b. increased NO production due to iNOS activity
c. hypothermia
d. accumulation of octopamine
e. severe hypotension
f. Normovolemia
g. decreased TPR
h. increased cardiac output
A

a/b/d/g/f/g/h

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4
Q 
4. Type of shock in which in the early phase the pale and sweaty skin is typical?
Select one or more:
a. Septic
b. Hypovolemic
c. Cardiogenic
d. Neurogenic
A

b/c

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5
Q
  1. Changes of laboratory parameters observed in shock:
    Select one or more:
    a. decreased serum phenylalanine and tyrosine levels
    b. increased blood urea nitrogen (BUN)
    c. decreased serum lactate level
    d. increased serum alanine and glutamine levels
    e. increased serum fibrinogen level
    f. increased serum glucose level
    g. decreased levels of acute phase proteins
    h. increased serum leu/tyr, leu/phe ratio
A

a/b/d/e/f/h

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6
Q 
6. Compensatory mechanisms in shock:
Select one or more:
a. chemoreceptor reflex
b. reabsorption of interstitial fluid
c. baroreceptor reflex
d. immune system activation
e. Reabsorption of tissue fluid
f. Cerebral ischemia
A

a/b/c/f

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7
Q
  1. Compensatory mechanisms in shock EXCEPT: ( red because it is a “rare” question”)
    a. immune system activation
    b. baroreceptor reflex
    c. chemoreceptor reflex
    d. cerebral ischemic reflex
A

a

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8
Q 
8. Cause(s) of hypovolemic shock:
Select one or more:
a. adrenocortical failure
b. diabetes insipidus
c. acute pancreatitis
d. generalized exfoliative dermatitise. Diarrhea
f. penicillin allergy
g. diabetes mellitus
h. pneumothorax
A

a/b/c/d/e/g

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9
Q 
9. Indicative of irreversible phase of shock
Select one or more:
a. gray, cyanotic skin
b. weak, suppressible pulse
c. comatose stage
d. sweating
A

c

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10
Q
  1. What is the shock index?
    Select one
    a. pulse rate (bpm) / RRsys (mmHg)
    b. respiratory rate (1/min) / mean arterial pressure (mmHg)
    c. pulse rate (bpm) / mean arterial pressure (mmHg)
    d. respiratory rate (1/min) / RRdias (mmHg
A

a

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11
Q 
11. Obstructive shock can be caused by:
Select one or more:
a. Pneumothorax
b. diabetes mellitus
c. heart tamponade
d. pulmonary embolization
e. ventricular fibrillation
f.acute pancreatitis
A

a/c/d

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12
Q 
12. Causes of cardiogenic shock:
Select one or more:
a. asthma cardiale
b. excessive burn
c. pericardial tamponade
d. valvular regurgitation or stenosi
e. Addison’s disease
f. severe systemic acidosis
g. pump function failure
h. spinal cord injury
A

a/c/d/f/g

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13
Q 
13. Possible causes of the decompensation in the late phase of shock:
Select one or more:
a. metabolic acidosis
b. endothelial injury
c. respiratory alkalosis
d. tachypnea
A

a/b

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14
Q 
14. Hypovolemic shock can be caused by:
Select one or more:
a. pulmonary embolism
b. diabetes mellitus
c. acute pancreatitis
d. pneumothorax
A

b/c

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15
Q 
15. Clinical signs characteristic to progressive phase of hypovolemic shock :
Select one or more:
a. tissue acidosis
b. decreased capillary filling
c. oliguria/anuria
d. acrocyanosis
A

a//b/c/d

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16
Q
  1. Alterations of kidney function in shock:
    Select one or more:
    a. Na+ retention
    b. oliguria/anuria
    c. If RR < 60 mmHg, high chance for tubular necrosis
    d. dec reased concentrating ability
    e. decreased GFR
    f. decreased concentrating ability
    g. polyuria
    h. If RR < 60 mmHg, high risk for glomerular damage
A

b/d/e//f

17
Q
  1. Changes of microcirculation in shock:
    Select one or more:
    a. hemodilution
    b. venoconstriction
    c. arterial/arteriolar vasoconstriction
    d. resistance of post capillary vessels are decreased
    e. edema
    f. hemoconcentration
    g. arterial/arteriolar vasoconstriction
    h. resistance of post capillary vessels are increased
A

a/b/c/g/h

18
Q 
18. Causes of distributive shock:
Select one or more:
a. spinal cord injury
b. allergic reaction triggered by penicillin
c. pulmonary embolism
d. sepsis
e. systemic acidosis caused by poisoning
f. spinal cord injury
g. Addison’s disease
h. chronic heart failure
A

a/b/d/f/

19
Q
  1. Immediate compensatory mechanisms induced by fluid depletion (BP: 90 mmHg):
    Select one or more:
    a. activation of low pressure receptors
    b. activation of the renin-angiotensin system
    c. activation of peripheral chemoreceptors
    d. central nervous system ischemic response
A

a/c/d

20
Q 
20. Clinical signs characteristic to compensated phase of hypovolemic shock:
Select one or more:
a. cold, pale extremities
b. bradycardia
c. tachypnea
d. SBP < 70 mmHg
e. acrocyanosis
f. decreased capillary filling
g. oliguria/anuria
h. tissue acidosi s
A

a/c/g

21
Q
  1. Alterations of bowel function in shock:
    Select one or more:
    a. increased permeability
    b. mesenteric vasoconstriction
    c. increased peristaltic activity
    d. bacteria invade into the blood or lymph
A

a/b/d

22
Q 
22. Characteristic findings in hyperdynamic stage of distributive shock:
Select one or more:
a. severe hypotension
b. normovolemia
c. decreased TPR
d. increased cardiac output
A

b/c

23
Q
  1. Criteria for appropriate tissue perfusion:
    Select one or more:
    a. structurally and functionally intact vasculature
    b. appropriate cardiac function
    c. normal volume and composition of perfusion fluid (Hb, plasma proteins, corpuscular elements etc.)
    d. normal lung function
A

a/b/c/d/

24
Q 
24. Factors enhancing the development of ARDS in shock :
Select one or more:
a. tachypnea
b. over activation of the immune system
c. bronchoconstriction
d. alveolar fluid accumulation
A

b/d

25
Q 
25. Clinical signs indicating circulatory shock:
Select one or more:
a. pallor
b. redness, fever
c. respiratory rate < 7/min
d. respiratory rate > 29/min
A

a/b/c/d

26
Q
  1. Mechanisms leading to the irreversible phase of hemorrhagic shock:
    Select one or more:
    a. increased sympathetic tone
    b. accumulation acidic metabolites
    c. contraction of precapillary sphincters
    d. microembolization
A

d

27
Q
  1. Causal factors of hyperdynamic stage in distributive shock:
    Select one or more:
    a. increased NO production due to iNOS activity
    b. accumulation of octopamine
    c. accumulation of lactic acid
    d. hypothermia
A

a/b/c

28
Q
  1. Indicative finding for shock if the shock index is:
    Select one:
    a. ≤ 0.5
    32

b. ≥ 1
c. ≤ 1
d. 0.5
e. BLANK - NO NUMBER
29. Cardiogenic shock can be caused by:
Select one or more:
a. rupture

A

b

29
Q 
29. Cardiogenic shock can be caused by:
Select one or more:
a. rupture of the septum
b. embolism
c. ventricular fibrillation
d. pneumothorax
A

a/b/c/d

30
Q
  1. Pathological changes of adipose tissue in shock:
    Select one or more:
    a. Increased lipolysis
    b. Increased glucose uptake in adipose tissue
    c. Development of hypoxia due to centralization of circulation
    d. Increased formation of ketone bodies in adipose tissue
A

c

31
Q
  1. (Characteristic) metabolic alterations in shock:
    Select one or more:
    a. increased glucose uptake by muscle cells
    b. decreased glucose oxidation in muscle cells
    c. increased serum glucose level
    d. increased proteolysis in the muscle
    e. increased ketogenesis
    f. decreased glucose oxidation in muscle cells
    g. decreased serum glucocorticoid level
    h. decreased lipolysis in adipose tissue
A

a/b/c/d/e/f/

32
Q
  1. Compensatory mechanism in shock:
    a. Chemoreceptor reflexes
    b. Baroreceptor reflexes
    c. Reabsorption of tissue fluid
    d. Cerebral ischemia
A

a/b/d

pathophys (17 decks)

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