Shock Lecture - Dr. Arnce

Question 1

SV determined by 3 things

Answer 1

Afterload, preload, myocardial contractility

Question 2

3 stages of shock

Answer 2

compesated, decompensated, irreversible

Question 3

physiologic 4 types of shock

Answer 3

cardiogenic, hypovolemic, distributive, obstructive

Question 4

Compensated shock

Answer 4

all reflex active to maintain BP , no decrease in BP

Question 5

decompensatory shock

Answer 5

BP drops despite all the reflexes in body activating

= lactic acidosis

Question 6

irreversible shock

Answer 6

organ and tissues are very injured and multiorgan failure

Question 7

Distributive

Answer 7

low resistance peripheral : sepsis, anaphylaxis, neurogenic shock, toxins (dilating of vasculature)

Question 8

Cardiogenic shock

Answer 8

pump problem, heart problem, (MI, HF, arrhythmia, myocarditis, VSD, valve prob, cardiomyopathy)

Question 9

Hypovolemic shock

Answer 9

hemorrhagic (bleeding out), dehydration fluid loss (D, V), ascites, burns

Question 10

Obstructive shock

Answer 10

Pulmonary Embolism, Cardiac tamponade, tension pneumothorax

Question 11

Cardiogenic shock :

1. CO
2. SVR
3. PCWP/ CVP (central circuit P, like in IVC)

Answer 11

1. decrease
2. increase
3. increase

Question 12

Hypovolemia shock :

1. CO
2. SVR
3. PCWP/ CVP (central circuit P, like in IVC)

Answer 12

1. decreased
2. increased
3. decreased

Question 13

Distributive shock SEPTIC, ANAPHYLACTIC :

1. CO
2. SVR
3. PCWP/ CVP (central circuit P, like in IVC)

Answer 13

1. increased
2. decreased
3. decreased

Question 14

Distributive shock NEUROGENIC :

1. CO
2. SVR
3. PCWP/ CVP (central circuit P, like in IVC)

Answer 14

1. decrease
2. decrease
3. decrease

Question 15

Obstructive shock :

1. CO
2. SVR
3. PCWP/ CVP (central circuit P, like in IVC)

Answer 15

1. decreased
2. increased
3. variable

Question 16

most common cause of cardiogenic shock

Answer 16

1. cardiomyopathies
   = MI
   = myocarditis
   = drugs (B-blockers, chemo, alcohol)

Question 17

Cardiogenic shock high HR

Answer 17

fib, flutter, tachy

Question 18

cardiogenic shock low HR

Answer 18

heart block

Question 19

shock sx

Answer 19

= hypotension 
= tachy
= oliguria
= abnormal mental status
= cool, clammy, cyanotic
= high RR
= metabolic Acidosis
= high serum lactate

Question 20

TX shock INITIAL

Answer 20

ABC

airway, breathing (and O2), circulation, disability neurologic, Exposure

Question 21

shock TX what you actually give

Answer 21

1. IV Fluid
2. Vasopressors
3. US evaluation to find cause if possible (and type of shock)
4. Broad spectrum ABs (infection or septic)

Question 22

children in shock

Answer 22

tachy only (hypotension comes later)

Question 23

elderly and shock

Answer 23

not always show tachy or hypotension (since many are on drugs)

Question 24

drug that can make a person in shock not have tachy

Answer 24

B-Blocker