Shock

Question 1

what is shock

Answer 1

critical imbalance between delivery of O2 and nutrients to cells and utilization of O2 and nutrients by cells
Delivery

Question 2

untreated shock (all forms) can cause

Answer 2

1) decreased peripheral ciculation (cold/pale)
2) decreased CO, decreased BP, weak pulse
3) decreased urine production (bc low BP= low functioning liver/kidney)
4) tissue anoxia/ death

Question 3

earliest signs of shock (all forms)

Answer 3

depressed/ anorexia, tachycardia, tachypnea

Question 4

what kind of shock is hypovolemic shock

Answer 4

fluid loss

Question 5

possible causes of hypovolemic shock

Answer 5

• deacreased blood volume in circulation= blood loss, dehydration, plasma loss (burn victims epithelial tissue not holding in moisture)
• severe diabetes (hypoglycemia from increase in insulin)
• v/d

Question 6

signs of hypovolemic shock

Answer 6

all bc of peripheral constriction (shuts down peripheral blood vessles)= prolonged CRT, weak pulse, pale/cyanotic MM, cool extremeties

Question 7

What kind of shock is Cardiogenic shock

Answer 7

lack of O2 delivery bc poor cardiac funciton

Question 8

possible causes of cardiogenic shock

Answer 8

heart disease (like cardiomyopathy), heart failure, vascular disorders, heartworm, tumors, hardware disease

Question 9

signs of cardiogenic shock

Answer 9

weak pulse, hypotension, pale MM, pulmonary edema (lungs filled w fluid) or acites (free fluid in abdomen)

Question 10

how hypovolemic shock is treated

Answer 10

restore intravascular volume (fluids or tranfusion)

Question 11

ways to treat cardiogenic shock

Answer 11

antiarrythmics, diuretics (remove fluid)

Question 12

why cardiogenic shock can cause pulmonary edema or acites

Answer 12

heat inefficiency causes an increase in venous pressure

Question 13

inefficiency on right side of heart v left

Answer 13

R= blood backed up in vena ceva (dilates and leaks)-> acites
L= blood backed up in L atria and pulmonary vein (dilates and leaks) -> pulmonary edema

Question 14

what is altered blood flow/ distributive shock

Answer 14

conditions that cause generalized vasodilation (and blood pooling) caused by inapropriate blood flow

Question 15

possible causes of altered blood flow/ distributive shock

Answer 15

drug side effects, heart stroke (dilates blood vessels), sepsis (systemic infection), anaphylaxis, CNS trauma

Question 16

common cause of altered blood flow/ distributive shock

Answer 16

HBC (hit by car)

Question 17

bodies are __% water, what percent of this is intracellular fluid __ %

Answer 17

60%, 30-40% intracellular

Question 18

extracellular fluid is made up of interstitial fluid and intravascular fluid, what are the differences between the two

Answer 18

interstitial= between cells (3/4 ECF)
intravascular= plasma in blood vessels (1/4 ECF)

Question 19

volume of circulating blood in dogs, cats, horses

Answer 19

dogs= 80-90 ml/kg
cats= 40-60 ml/kg
horses= 80 ml/kg

Question 20

cell membranes and blood vessels have different degrees of permiability.
which can water move thro? electrolytes? colloids?

Answer 20

water= can move thro cell membranes and blood vessel walls
electrolytes= can move thro BV walls, stays in ECF, cant go into cells
colloids= cant move thro either, stays in blood vessles

Question 21

what is osmolality

Answer 21

concentration

Question 22

difference between hypotonic, isotonic, and hypertonic osmolality in comparison to blood

Answer 22

hypo= osmolality blood

Question 23

components of a crystalloid fluid

Answer 23

water+ small molecular weight electrolytes

Question 24

difference between colloid and crystaloid fluids (where they go)

Answer 24

colloids= stays in vascular system (intravascular fluid)and doesnt diffuse into interstitial fluid (bc large molecular weight solutes)
crystalloids= readily diffuse in and out of vascular system (anywhere within ECF)

Question 25

what kind of fluid would we give for extreme head trauma

Answer 25

hypertonic fluid, shifts fluid from interstitial -> vascular space (like hypertonic saline) (draws off edema/ swelling)

Question 26

Shock volume ( emergency high amount of fluids) for dogs, and cats (first 15 min v first hour)

Answer 26

dogs= 20-40 ml/kg over first 15 min
70-90 ml/kg over first hour

cats= 10-20 ml/kg over first 15 min
35-50ml/kg first hour

Question 27

normal amount of fluids one would give a cat/dog in a DAY

Answer 27

dog= 25-30ml/kg
cat= 12-18 ml/kg

Question 28

fluid pump vs buretrol

Answer 28

fluid pump= not dep on postion of patient or gravity, maintains amount delivered
buretrol= gravity fed, prevents over hydration, has to be replenished

Question 29

signs of overhydration

Answer 29

increased lung sounds, increased BP, serous (clear) nasal discharge, edema, conjuntiva edema (check weight/ urine output)

Question 30

aditional therapies for shock

Answer 30

O2
warm the animal
drugs

Question 31

why glucocorticoids(steroids) are sometimes used as therapy for shock

Answer 31

stabilize blood vessels (decreasing leakiness), causes vasoconstriction, anti-inflammatory

Question 32

how to treat septic shock (form of altered bloodflow/ distributive shock) specifically

Answer 32

antibiotics

Question 33

how to treat cardiogenic shock specifically

Answer 33

lidocaine to decrease arrythmias, cardiac inotropes ( drugs that increase strength of muscles like dobutamine, dopamine, ephedrine)

Question 34

how to treat shock caused by trauma (distributive shock)

Answer 34

replace fluids (blood or saline), anti-inflammatories, analgesics

Question 35

how to treat toxic shock (form of distributive shock)

Answer 35

antitoxin or antivenom

Question 36

how to treat anaphylactic shock

Answer 36

antihistimines (diphenhydramine/ Benadryl), epinephrine (if severly dyspnic (opens airways)