Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Board Exam > Shock States > Flashcards

Shock States Flashcards

1
Q

central venous pressure

A

A measure of the pressure exerted by fluid in the right atrium
Indicative of right-sided heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

normal CVP

A

0-6 mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Elevated CVP

A

conditions that cause an increase in the amount of fluid in the right atrium (e.g. fluid overload, cardiogenic shock)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Decreased CVP

A

conditions that cause a decrease in the amount of fluid in the right atrium (e.g. dehydration, distributive shock)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

mean arterial pressure

A

indicates the average driving force in the arterial system throughout the cardiac cycle
When available, MAP should be used in hemodynamic assessment and decision making

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How to calculate MAP

A

MAP = [SBP + 2(DBP)]/3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pulmonary arterial pressure (PAP)

A

a measure of the systolic and diastolic pressures in the pulmonary artery (15-25/5-15)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

elevated PAP

A

caused by conditions that increase the amount of fluid in the pulmonary artery or conditions that decrease the elasticity of the pulmonary artery (e.g. hypervolemia, pulmonary hypertension)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

decreased PAP

A

conditions that cause a decrease in the amount of fluid in the pulmonary artery (e.g. hypovolemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

pulmonary capillary wedge pressure (PCWP) or Pulmonary Artery Occlusion Pressure (PAOP)

A

measure of the pressure in the left ventricle at end-diastole (maximal stretch)
indicative of left-sided heart function

Reflection of the tendency to develop pulmonary edema
Should be kept at the lowest point at which cardiac performance is acceptable to optimize cardiac performance and minimize tendency for pulmonary edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

normal PCWP

A

6-12 mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

increased PCWP

A

conditions that increase the pressure in the left ventricle at end-diastole (e.g. increased fluid, decreased elasticity of the ventricle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

decreased PCWP

A

conditions that decrease the pressure in the left ventricle at end-diastole (e.g. hypovolemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

cardiac output

A

amount of fluid in liters per minute that the heart pumps into systemic circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How to calculate cardiac output

A

CO = HR x SV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

normal cardiac output

A

4-8 L/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

increased CO

A

increased by factors that increase the heart rate or increase the amount of blood that the heart puts out with each beat (e.g. inotropic agents, excess fluid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

decreased CO

A

decreased by factors that decrease heart rate or decrease the amount of blood that the heart puts out with each beat (e.g. drugs that decrease contractility, hypovolemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

cardiac index (CI)

A

CO/body surface area
More accurate than cardiac output because it takes body surface area into account

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

normal cardiac index

A

2.5-4 L/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

stroke volume

A

volume of blood pumped out of the left ventricle during each systolic contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

systemic vascular resistance (SVR)

A

the resistance provided by the systemic circulation against which the left ventricle must pump blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How to calculate SVR

A

SVR = (MAP - mean CVP x 80) / CO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

normal SVR

A

800-1200 dynes/sec/cm-5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
mixed venous o2 saturation (SVO2)
continuous display of mixed venous oxygen saturation by the pulmonary artery catheter Assesses the effectiveness of peripheral oxygen delivery
26
normal SVO2
60-80%
27
low SVO2
implies increased tissue extraction of O2 The patient has tapped the venous reserve of O2 Needs more O2 Causes: -decreased O2 supply (e.g. decreased CO, decreased FiO2, anemia) -increased O2 demand (e.g. fever, shivering, increased WOB)
28
high SVO2
implies decreased tissue extraction of O2 high return of O2 is often a most early indicator of patient status change Not using O2 (worse than too low) Causes -increased O2 supply (e.g. FiO2 > need) -decreased O2 demand (e.g. hypothermia) -decreased effective O2 delivery and uptake by the cells (e.g. sepsis, shift of oxyhemoglobin cures to the left)
29
hypovolemic shock: labs -CO/CI -CVP -PCWP -SVR -SVO2
CO/CI: low CVP: low PCWP: low SVR: high SVO2: low *hypovolemic --> less pressure --> everything is low except SVR which is compensating*
30
cardiogenic shock: labs -CO/CI -CVP -PCWP -SVR -SVO2
CO/CI: low CVP: high PCWP: high SVR: high SVO2: low *acute pump failure --> ineffective pump --> blood stays in the heart*
31
septic shock: labs -CO/CI -CVP -PCWP -SVR -SVO2
**CO/CI: high then low** CVP: low then high PCWP: low then high SVR: low SVO2: low then high *severe hypotension in response to infection* *Similar to the other types of distributive shock, everything is low*
32
anaphylactic shock: labs -CO/CI -CVP -PCWP -SVR -SVO2
CO/CI: low CVP: low PCWP: low SVR: low SVO2: low *ALLergen --> ALL values are low* *Similar to the other types of distributive shock, everything is low*
33
neurogenic shock: labs -CO/CI -CVP -PCWP -SVR -SVO2
CO/CI: low CVP: low PCWP: low SVR: low SVO2: low *Similar to the other types of distributive shock, everything is low*
34
obstructive shock: labs -CO/CI -CVP -PCWP -SVR -SVO2
CO/CI: low CVP: high PCWP: normal/low SVR: high SVO2: high *Blockage --> blood backs up into R ventricle --> R atrium (CVP high)*
35
hypovolemic shock
results from a loss of >20% of circulating blood volume
36
hypovolemic shock: causes
internal/external bleeding burns DKA/HHNK severe dehydration
37
hypovolemic shock: management
Isotonic fluids vasopressors (e.g. norepinephrine, dopamine) and/or dobutamine (inotropic) PRBC if H/H low
38
cardiogenic shock
a loss of effective contractile function results in impaired cardiac output, impaired oxygen delivery, and reduced tissue perfusion (acute pump failure)
39
cardiogenic shock: causes
acute MI: most common cause ventricular aneurysm dysrhythmia pericardial tamponade hypoxemia pulmonary edema acute valvular regurgitation acute ventricular septal defect
40
cardiogenic shock: management
initial, careful administration of fluids vasopressor support (e.g. norepinephrine, dopamine) and/or dobutamine (inotropic)
41
distributive shock
three forms of shock characterized by massive vasodilation, decreased intravascular volume, reduced peripheral vascular resistance, and loss of capillary integrity
42
septic shock
Type of distributive shock Severe hypotension in spite of adequate fluid resuscitation that is caused by the body's overwhelming secondary response to infection
43
Septic shock: management
Fluid resuscitation Blood cultures Antibiotics within 1 hour vasopressors (e.g. norepinephrine, dopamine) and/or dobutamine (inotropic)
44
anaphylactic shock
Type of distributive shock IgE mediated reaction that occurs shortly after exposure to an allergen
45
anaphylactic shock: management
Maintain airway Crystalloids for volume expansion Benadryl 25-75mg IV or IM Epinephrine 0.3-0.5 mg SQ or IM for respiratory distress IV glucocorticoids as needed Consider H2 antagonist (e.g. famotidine) inhaled beta agonist for bronchospasm (e.g. albuterol)
46
neurogenic shock
type of distributive shock Loss of peripheral vasomotor tone as a result of spinal cord injury, regional anesthesia, etc.
47
neurogenic shock: management
Maintain airway crystalloids for volume expansion vasopressors (e.g. phenylephrine, norepinephrine)
48
obstructive shock
inadequate cardiac output as a result of impaired ventricular filling
49
obstructive shock: causes
massive PE: most common cause tension pneumothorax acute cardiac tamponade obstructed valvular disease disease of pulmonary vasculature
50
obstructive shock: management
Maintain BP while treating underlying cause fluid administration vasopressors (e.g. norepinephrine) mechanical ventilation as indicated anticoagulation as indicated
51
toxic shock syndrome: pathogen
staphylococcus aureus
52
toxic shock syndrome: management
aggressive IV fluid hydration fever control empiric treatment with clindamycin and vancomycin pressor support if needed remove tampon
53
qSOFA criteria
1 point for each criteria; 2+ points near the onset of infection is associated with greater risk of death or prolonged ICU stay. 1. low BP (SBP <100 mm Hg) 2. high RR (>22) 3. altered mentation (GCS <15)
54
cardiogenic shock: S/Sx
tachypnea, severe SOB tachycardia, weak pulse hypotension LOC diaphoresis pallor cold hands or feet oliguria, anuria
55
hypovolemic shock: S/Sx
tachypnea hypothermia hypotension tachycardia confusion, anxiety, LOC diaphoresis cool skin weakness
56
septic shock: S/Sx
tachycardia hypothermia or fever tachypnea, SOB hypotension shaking, chills warm, clammy, or sweaty skin confusion lightheadedness oliguria, anuria palpitations rash
57
anaphylactic shock: S/Sx
hypotension tachycardia, weak pulse wheezing, constriction of airways urticaria, pruritis flushed or pale skin N/V/D dizziness, LOC
58
neurogenic shock: S/Sx
hypotension bradycardia flushed, warm skin that gets cold and clammy later circumoral cyanosis LOC
59
obstructive shock: S/Sx
tachypnea hypotension tachycardia Altered LOC oliguria cool, clammy skin subcutaneous emphysema chest, abdominal pain
60
refractory shock: criteria, management
SBP <90 for more than one hour following adequate fluid resuscitation and vasopressors IV glucocorticoids are not routinely used as part of initial therapy and should be used on a case-by-case basis -preferred medication: hydrocortisone alone

Board Exam (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions