Shock Flashcards
___ is determined by the radius of the resistance vessels
systemic vascular resistance (SVR)
Blood pressure formula:
BP =
CO x SVR
__ is measured through central line
a. PAOP
b. CVP
b. CVP
__ is measured through PA catheter or Swan-Ganz
PAOP
__ is an estimate of tight atrial pressure (preload)
central venous pressure (CVP)
__ is an indirect estimate of left atrial pressure (preload) aka pulmonary capillary wedge pressure (PCWP)
pulmonary artery occlusion pressure (PAOP)
Hemorrhage and severe dehydration are a __ problem
a. pump
b. fluid
c. pipe
b. fluid
hypovolemic
PE and tamponade are a __ problem
a. pump
b. fluid
c. pipe
a, c
pipe and or pump
obstructive
Sepsis and anaphylaxis are a __ problem
a. pipe
b. pump
c. fluid
a. pipe
distributive
In hypovolemic shock which are increased/decreased?
CVP
PCWP
CO
SVR
CVP: decreased
PCWP: decreased
CO: decreased
SVR: increased
only SVR is increased
In cardiogenic shock which are increased/decreased?
CVP
PCWP
CO
SVR
CVP: increased
PCWP: increased
CO: decreased
SVR: increased
only CO decreased
In obstructive shock (tamponade) which are increased/decreased?
CVP
PCWP
CO
SVR
CVP: increased
PCWP: increased
CO: decreased
SVR: increased
only CO is decreased
In obstructive shock (PE) which are increased/decreased?
CVP
PCWP
CO
SVR
CVP: increased
PCWP: increased or normal
CO: decreased
SVR: increased
In distributive shock (pre-resuscitation which are increased/decreased?
CVP
PCWP
CO
SVR
CVP: decreased
PCWP: decreased
CO: decreased
SVR: decreased
all decreased
In distributive shock (post-resuscitation) which are increased/decreased?
CVP
PCWP
CO
SVR
CVP: increased
PCWP: increased
CO: increased
SVR: decreased
only SVR is decreased
osmolarity formula:
osm =
2na + (BUN/2.8) + (glucose/18)
What is normal osmolarity of blood?
300 mOsm/L
What is lower limit of tolerable osmolarity?
150mOsm/L
alpha 1 receptors are associated with ___
a. vasodilatoin
b. vasoconstriction
c. increased blood volume
d. increased chronotropy
b. vasoconstriction
alpha 2 receptors are associated with __
a. vasodilatoin
b. vasoconstriction
c. increased blood volume
d. increased chronotropy
a. vasodilation
beta 1 receptors are associated with __
a. vasodilatoin
b. vasoconstriction
c. increased blood volume
d. increased chronotropy
d. increased chronotropy
beta 2 receptors are associated with __
a. vasodilatoin
b. vasoconstriction
c. increased blood volume
d. increased chronotropy
a. vasodilation
dopamine is associated with ___
a. vasodilatoin
b. vasoconstriction
c. increased blood volume
d. increased chronotropy
b. vasoconstriction
vasopressin 1 is associated with ___
a. vasodilatoin
b. vasoconstriction
c. increased blood volume
d. increased chronotropy
b. vasoconstriction
vasopressin 2 is associated with ___
a. vasodilatoin
b. vasoconstriction
c. increased blood volume
d. increased chronotropy
c. increased blood volume
First line vasopressor for cardiogenic shock?
norepinephrine
dopamine is NOT recommended
Which inotrope has some alpha receptor activity?
a. milrinone
b. isoproterenol
c. dobutamine
c. dobutamine
increases CO
vasodilation
also vasoconstriction
Initial fluid challenge for distributive shock is at least __ mL/kg of crystalloid
30
What is goal MAP in septic shock?
at least 65mmHg
Obstructive shock (acute PE):
Which thrombolytic is fibrin selective and has a short half life of 5 minutes?
alteplase
