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Pathological Basis of Disease I > Shock - SRS > Flashcards

Shock - SRS Flashcards

1
Q

What is shock?

A

•The inability of the body to deliver adequate amounts of O2 to the cell or for the cell to utilize it.

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2
Q

How is shock manifested metabolically?

A

•shock is manifested by the cell shifting from aerobic to anaerobic metabolism

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3
Q

What happens to body pH levels in shock?

A

Metabolic acidosis arises due to accumulation of lactic acid by products of anaerobic metabilism

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4
Q

What are the five types of shock?

A
  1. Hypovolemic
  2. cardiogenic
  3. extracardiac/pbstructive
  4. distributive
  5. dissociative
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5
Q

What leads to hypovolemic shock?

A

Blood or fluid loss, both leading to decreased circulating blood volume, diastolic filling pressure and volume

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6
Q

What are four causes of hypovolemic shock?

A
  1. Hemorrhagic
  2. Fluid depletion
  3. Interstitial fluid redistribution
  4. Increased vascular capacitance
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7
Q

What leads to cardiogenic shock?

A
  1. Myopathic - Infarcts
  2. Myocardial contusion
  3. Mechanical - valve failure etc.
  4. Arrythmias
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8
Q

What leads to extracardiac/obstructive shock?

A

Obstruction to flow in the cardiovascular circuit that leads to inadequate diastolic filling or decreased systolic function because of increased afterload.

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9
Q

What are examples of things that can cause extracardiac/obstructive shock?

A

Impaired diastolic filling

Increased intrathoracic pressure

decreased cardiac compliance

Impaired systolic contraction

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10
Q

Describe distributive shock.

(sorry)

A

Arterial and venous dilation leads to a decrease in preload with decreased, normal or elevated cardiac output, depending on the presence of myocardial depression.

Inflammatorry causes produce microcirculatory dysfunction, hypotension and multiple organ system dysfunction without a decrease in cardiac output.

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11
Q

What kind of shock will the following likely lead to?

Sepsis (bacterial, fungal, viral, rickettsial

Toxic shock syndrome

Anaphylactic anaphylactoid

neurogenic (spinal shock)

adrenal crisis

thyroid storm

A

Distributive

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12
Q

What kind of shock am I describing?

A

Impairment of oxygen utilization or impairment of the cellular machinery.

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13
Q

What kind of sepsis would these lead to?

Toxic stuff - nitroprusside, cyanide, bretylium

End stage sepsis

Catecholamine toxicity

A

Distributive

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14
Q

Describe what you would see for the following items in hypovolemic shock:

  1. CVP and PCWP (central venous pressure & pulmonary capillary wedge pressure)
  2. Cardiac output
  3. systemic vascular resistance
  4. venous O2 saturation
A
  1. Decrease
  2. Decrease
  3. Increase
  4. Decrease
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15
Q

Describe what you would see for the following items in cardiogenic shock:

  1. CVP and PCWP (central venous pressure & pulmonary capillary wedge pressure)
  2. Cardiac output
  3. systemic vascular resistance
  4. venous O2 saturation
A
  1. Increase
  2. Decrease
  3. Increase
  4. Decrease
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16
Q

Describe what you would see for the following items in hyperdynamic septic shock:

  1. CVP and PCWP (central venous pressure & pulmonary capillary wedge pressure)
  2. Cardiac output
  3. systemic vascular resistance
  4. venous O2 saturation
A
  1. Up or down
  2. increase
  3. decrease
  4. increase
17
Q

Describe what you would see for the following items in hypodynamic septic shock:

  1. CVP and PCWP (central venous pressure & pulmonary capillary wedge pressure)
  2. Cardiac output
  3. systemic vascular resistance
  4. venous O2 saturation
A
  1. up or down
  2. decrease
  3. increase
  4. Up or down
18
Q

Describe what you would see for the following items in traumatic septic shock:

  1. CVP and PCWP (central venous pressure & pulmonary capillary wedge pressure)
  2. Cardiac output
  3. systemic vascular resistance
  4. venous O2 saturation
A
  1. decrease
  2. increase or decrease
  3. increase or decrease
  4. decrease
19
Q

Describe what you would see for the following items in neurogenic shock:

  1. CVP and PCWP (central venous pressure & pulmonary capillary wedge pressure)
  2. Cardiac output
  3. systemic vascular resistance
  4. venous O2 saturation
A
  1. decrease
  2. decrease
  3. decrease
  4. decrease
20
Q

Describe what you would see for the following items in hypoadrenal shock:

  1. CVP and PCWP (central venous pressure & pulmonary capillary wedge pressure)
  2. Cardiac output
  3. systemic vascular resistance
  4. venous O2 saturation
A
  1. Increase or decrease
  2. decrease
  3. same or decrease
  4. decrease
21
Q

There are some flow charts that might be worth a look in the power point…

A

I’m moving on to other material at this point though. This lecture is no good.

Pathological Basis of Disease I (11 decks)

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