Week 11: Shocks and Burns

Question 1

What is shock?

Answer 1

A multi systemic syndrome, that represents the failure of multiple systems

Question 2

What is the common dominator in shock?

Answer 2

That the microcirculatory fails

Question 3

What is microcirculation?

Answer 3

Responsible for providing oxygen and nutrients to every single cell in the body

Question 4

What is the microcirculation formed by?

Answer 4

Capillaries, arterioles and venules

Question 5

What does shock always have?

Answer 5

A casket of events that induces further damage aka positive feedback loop

Can result in multi organ failure

Question 6

What is very common during shock?

Answer 6

Cellular alterations

Question 7

What happens to the cells during shock?

Answer 7

They don’t have adequate blood supply

There’s damage/death in the cells and damage to membrane permeability

Question 8

What happens in regards to sodium and potassium in the cells during shock?

Answer 8

Na + K pumps are affected, the sodium is retained causing edema

This also results in altered ATP production

Question 9

What is the biggest issue in shock?

Answer 9

Impaired oxygen and glucose delivery due to microcirculatory failure.

Question 10

How does impaired oxygen delivery affect metabolism?

Answer 10

Decreased ATP leads to increased lactate, causing acidosis.

Question 11

What is a positive feedback loop with impaired oxygen delivery in shock?

Answer 11

Acidosis decreases oxygen affinity for hemoglobin, worsening oxygen delivery.

Question 12

What causes hypovolemic shock?

Answer 12

Insufficient intravascular fluid volume.

Question 13

What are common causes of hypovolemic shock?

Answer 13

Hemorrhage and severe burns.

Question 14

How much blood loss can trigger a shock response?

Answer 14

15% of total blood volume.

Question 15

What does the RAAS system do in hypovolemic shock?

Answer 15

Releases aldosterone to retain sodium and water.

Question 16

Why does hypovolemic shock cause pale skin?

Answer 16

Blood is shunted to vital organs.

Question 17

What causes cardiogenic shock?

Answer 17

Left heart failure leading to decreased cardiac output.

Question 18

What compensatory mechanisms occur in cardiogenic shock?

Answer 18

Sympathetic response, ADH release, and RAAS activation.

Question 19

Why do compensatory mechanisms in cardiogenic shock fail?

Answer 19

Increased myocardial oxygen demand worsens ischemia.

Question 20

Why is cardiogenic shock dangerous in heart attacks?

Answer 20

It reduces cardiac output and tissue perfusion, worsening heart failure.

Question 21

What causes neurogenic shock?

Answer 21

Damage to the brainstem or spinal cord.

Question 22

Why does neurogenic shock cause widespread vasodilation?

Answer 22

Loss of sympathetic control.

Question 23

What happens to blood pressure in neurogenic shock?

Answer 23

It drops due to massive vessel dilation.

Question 24

How does neurogenic shock impair cardiac output?

Answer 24

The heart cannot compensate for the widespread drop in blood pressure.

Question 25

What causes anaphylactic shock?

Answer 25

Type I hypersensitivity reaction mediated by IgE and mast cells.

Question 26

What chemical is released in anaphylactic shock?

Answer 26

Histamine.

Question 27

How does histamine affect blood vessels?

Answer 27

Increases capillary permeability, leading to massive fluid loss.

Question 28

What is a common emergency treatment for anaphylactic shock?

Answer 28

Epinephrine (EpiPen).

Question 29

What causes septic shock?

Answer 29

Bacterial infection spreading through the blood (septicemia).

Question 30

What type of bacteria commonly causes septic shock?

Answer 30

Gram-negative bacteria due to endotoxins (LPS).

Question 31

What systemic response occurs in septic shock?

Answer 31

Inflammation in every organ.

Question 32

What is the role of LPS in septic shock?

Answer 32

Triggers widespread immune activation and inflammation.

Question 33

Can gram-positive bacteria cause septic shock?

Answer 33

Yes, but it is more common with gram-negative bacteria.

Question 34

What is MODS?

Answer 34

Multi-organ failure due to shock or sepsis.

Question 35

How quickly can MODS develop?

Answer 35

Within 24 hours.

Question 36

Where is MODS most commonly seen?

Answer 36

Intensive Care Units (ICUs).

Question 37

What happens if organ failure lasts more than 4 days in MODS?

Answer 37

The prognosis worsens.

Question 38

What major pathophysiological events occur in MODS?

Answer 38

ARDS, acute renal failure, and disseminated intravascular coagulation (DIC).

Question 39

Why is DIC dangerous in MODS?

Answer 39

Causes both thrombosis and severe bleeding.

Question 40

What causes burns?

Answer 40

Physical or chemical damage to the skin.

Question 41

What are common causes of burns?

Answer 41

Heat, acid, and alkaline agents.

Question 42

What are the three types of burns?

Answer 42

First-degree, second-degree, and third-degree burns.

Question 43

What does a first-degree burn affect?

Answer 43

The epidermis only.

Question 44

What does a second-degree burn affect?

Answer 44

The dermis, causing blisters.

Question 45

What does a third-degree burn affect?

Answer 45

The hypodermis, destroying tissues and blood vessels.

Question 46

What is the Rule of Nines?

Answer 46

A method to estimate the percentage of body surface burned.

Question 47

How can severe burns lead to shock?

Answer 47

Extensive burns cause fluid loss, leading to hypovolemic shock.

Question 48

What causes inflammation in burns?

Answer 48

Tissue damage triggers vasodilation and edema.

Question 49

Why do blisters form in burns?

Answer 49

Damage to the epidermis and dermis leads to fluid accumulation.

Question 50

What is fibrosis in burns?

Answer 50

Scar tissue formation that can limit movement.

Question 51

How can burns affect the airway?

Answer 51

Smoke inhalation can inflame and scar the mucosa.

Question 52

What systemic complications can burns cause?

Answer 52

Edema, hypovolemic shock, and myoglobin release leading to acute tubular necrosis.

Question 53

Why does stress response worsen burn outcomes?

Answer 53

Sympathetic activation increases cardiovascular strain.

Question 54

Why do burn patients have a higher risk of infection?

Answer 54

Skin barrier loss makes them more susceptible to hospital-acquired infections.

Question 55

What is the refractory stage of shock?

Answer 55

Irreversible damage and multi-organ failure occur, leading to death.

Question 56

Why does DIC occur in shock?

Answer 56

Widespread endothelial damage activates clotting pathways.

Question 57

What is DIC?

Answer 57

A condition where excessive clotting depletes clotting factors, leading to hemorrhage.