Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

VTS ECC Caroline > Week 2 - Shock And Stabilization > Flashcards

Week 2 - Shock And Stabilization Flashcards

1
Q

Name conditions associated with distributive shock?

A

SIRS/Sepsis
Anaphylaxis/Anaphylactoid
Neurogenic
Neurogenic

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

Name conditions associated with obstructive shock?

A

Cardiac tamponade
Pleural space disease (effusion, pneumothorax, diaphragmatic hernia)
Pulmonary thromboemboli
GDV

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

What conditions are associated with non-circulatory shock?

A

Metabolic - mitochondrial dysfunction
Decreased O2 content - anaemia, Hb impairment

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

What is the equation for cardiac output?

A

Stroke volume x heart rate

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

What equation is this?
(SaO2 x Hb (g/l) x 1.37) + (PaO2 (mmHg) x 0.003

A

CaO2 - arterial oxygen content (ml/L)

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

What is the equation for delivery of oxygen DO2?

A

CO x CaO2

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

What is hypoxia?

A

Inadequate DO2 to meet the VO2 of the body

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

What are the 4 causes of hypoxia?

A

Decreased inspired O2
Inadequate tissue perfusion
Increased O2 demand
Cellular inability to DO2

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

What is the oxygen extraction ratio?

A

VO2 / DO2

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

What is critical O2 delivery?

A

O2 decreased, cells switch from aerobic to anaerobic metabolism.

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

What is hypoxemic hypoxia?

A

Decreased DO2 due to decreased CaO2 secondary to hypoxaemia from a decreased PaO2 and SaO2.

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

What is hypaemic hypoxia?

A

Decreased Hb thus reduces CaO2 thus decreasing DO2.

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

What is haemoglobinopathy?

A

Adequate Hb but Hb dysfunctional and unable to transport O2 sufficiently.

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

What is Stagnant/circulatory hypoxia?

A

Low CO and low blood load, leading to decreased DO2.

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

What is histotoxic hypoxia?

A

Adequate DO2 but tissues unable to extract and utilise O2.

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

Name a condition associated with histotoxic hypoxia?

A

Cyanide toxicity
Carbon monoxide toxicity
Mitochondrial dysfunction - Sepsis

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

What is metabolic hypoxia?

A

Adequate DO2 but increased VO2 demand (not enough to go around).
E.g. sepsis

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

Define shock.

A

VO2 exceeds DO2 and cells enter anaerobic metabolism.

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

What is dysoxia?

A

Cells unable to utilise O2 (Hisotoxic hypoxia).

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

What is apoptosis?

A

Cell death - leads to organ failure.

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

What is hypovolaemic shock?

A

Reduced volume in the intravascular space leading to decreased preload and cardiac output.

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

What is relative hypovolaemic shock?

A

Internal fluid shift from intravascular space e.g. internal haemorrhage, third spacing, massive vasodilation -sepsis.

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

What is absolute hypovolaemic shock?

A

External haemorrhage, excessive fluid loss e.g vomiting, diarrhoea, polyuria, endocrine disease.

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

What is distributive shock?

A

Systemic vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Give examples of conditions associated with distributive shock?

A

SIRs, SEPSIS, anaphylaxis/anaphylactoid, neurogenic shock.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is cardiogenic shock?

A

Pump failure - contracting/filling leading to decreased CO and tissue hypoxia despite adequate intravascular volume.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Name conditions associated with cardiogenic shock?

A

Arrhythmias
Structural defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Define obstructive shock.

A

Obstruction around the heart of blood vessels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Give examples of conditions causing obstructive shock.

A

ATE
GDV
Pleural space disease
Cardiac tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Blood back up in the right side of the heart leads to?

A

Cardiomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Blood back up in the left side of the heart leads to?

A

Pulmonary oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Blood back up in the veins leads to?

A

Jugular venous distension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is neurogenic shock?

A

Synthetic nervous system loses ability to stimulate nerve impulse - above T6 injury.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Give the clinical symptoms of compensatory shock

A

Increased: CO, BP, perfusion
Tachycardia, bounding pulses, brief CRT, pink MMC.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Give the clinical symptoms of early de-compensatory shock

A

Lactic acidosis
Tachycardia
Pulses weakening
Pale MMC, prolonged CRT
Tachypnoea, increased respiratory effort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Give the clinical symptoms for late decompensatory shock

A

Decreased CO and DO2
Bradypnoea, bradycardia, Hypotension, weak pulses, pale/cyanotic MMC, prolonged CRT, hypothermia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

In late decompensatory shock, what complications may present?

A

Protein loss due to increased epithelial permeability
Coagulopathies, DIC
AKD, ARDs, MODs
Dysrhythmias
Decreased mentation, coma and death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Define SIRs

A

Systemic inflammatory response syndrome secondary to widespread tissue isheamia and reperfusion injury.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Why does bacterial translocation occur in SIRs and what might result?

A

Intestinal tract is a portal for systemic inflammation and increased permeability leads to barrier dysfunction.
Sepsis may present.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Define DIC

A

Inflammation induced activation of the coagulation pathway leads to microthrombosis and DIC.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is the blood volume of the cat?

A

60ml/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the blood volume of the dog?

A

90ml/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are the three factors for Virchow Triad?

A

Vascular stasis
Hypercoagulability
Vascular trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are the common places for catheter related blood stream infections to present?

A

Joint (hip/stifle)
Bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Fluid bolus recommendation dose?

A

5 - 20ml/kg over 10 - 20 minutes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Hypertonic fluids cause?

A

A rapid fluid shift into the intravascular space causing rapid expansion of the intravascular fluid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Synthetic colloids are out of favour as they have been associated with?

A

Coagulapthies
AKI
Increased mortality

48
Q

Natural colloids rescusitation rates are associated with?

A

Transfusion reaction
TACO - Transfusion-associated circulatory overload
TRALI - Transfusion-related acute lung injury

49
Q

What is a massive transfusion and how is it delivered?

A

Plasma, pRBC, platelets
1:1:1

50
Q

lactatemia A is associated with?

A

Tissue hypoperfusion
Hypoxaemia

51
Q

lactatemia B is associated with?

A

Underlying disease
Toxicity
Metabolic deficiency

52
Q

Anaphylactoid are non-immunological events. What might cause this?

A

Heat
Cold
pharmaceutical’s

Cause degranulation of mast cells and basophils

53
Q

Type 1 hypersensitivity reactions (anaphylaxis) is mediated by?

A

IGE

54
Q

In the dog, which two systems are usually affected with anaphylactic reaction?

A

Gi
Integumentary

55
Q

In the cat, which two systems are usually affected with anaphylactic reaction?

A

Respiratory
GI

56
Q

With anaphylaxis, what may be seen on POCUS?

A

Gall bladder oedema - halo sign

57
Q

What blood parameter is increased with anaphylaxis?

A

ALT

58
Q

What drugs are given to anaphylaxis patients?

A

Antihistamines
Glucocorticoids
Epinephrine (first line, temporary)
Bronchodilators - Albuterol/terbutaline

59
Q

What is reperfusion injury?

A

Cellular dysfunction and death following restoration of blood flow to previously ischemic tissues.

60
Q

With reperfusion injury, free radicals in the intravascular system may cause what arrhythmia?

A

VPCs

61
Q

Name common conditions/events associated with reperfusion injury.

A

GDV
ATE
CPR
Crush injury
Myocardial infarction

62
Q

What are the three compartments of reperfusion injury?

A

Myocardial oedema
Calcium deposits
Microvascular obstruction

63
Q

What percentage of blood loss will haemorrhagic shock present?

A

15 - 20 %

64
Q

Define permissive hypotension?

A

Lowest acceptable BP to maintain adequate vasoconstriction until definitive haemorrhage control obtained.

65
Q

What % of body water is intracellular fluid?

A

40%

66
Q

What % of body water is extralcellular fluid?

A

20%

67
Q

What is the % of body water of interstitial fluid?

A

15%

68
Q

What is the % of body water of plasma?

A

4%

69
Q

What is the % of body water of trancellular fluid?

A

1%

70
Q

What is Isotonic fluid loss and how is it lost?

A

Water and solutes
Vomiting
Diarrhoea

71
Q

What is hypotonic fluid loss and how does it occur?

A

Free water losses
Diabetes insipidus

72
Q

What is hypertonic fluid loss and how does this occur?

A

High concentration of sodium
Addison’s disease
Third spacing

73
Q

With dehydration, where is fluid lost from?

A

Interstitial and intracellular space

74
Q

In hypovolaemia, where is fluid lost?

A

Intravascular space

75
Q

What are the clinical symptoms of 10 - 12 % dehydration?

A

Severe loss of skin elasticity
Sunken eyes
Dry MM
Progressive signs of shock

76
Q

What are the clinical signs of 8-10% dehydration?

A

Marked loss of skin elasticity
Sunken eyes
Dry MM

77
Q

What are the signs of 6-8% dehydration?

A

Loss of skin elasticity
Slightly sunken eyes
Tacky MM

78
Q

What are the signs of 5-6% dehydration?

A

Subtle loss of skin elasticity

79
Q

What are the signs of 0-5% dehydration?

A

Not clinically detectable

80
Q

When using crystalloids, over what time frame does 60% - 80% of the solution leave the intravascular space?

A

20-30 minutes

81
Q

Hypotonic fluids are contraindicated with?

A

Hypovolaemia

82
Q

Hypertonic saline may be administered to large dogs to rapidly expand the intravascular space, however what is the duration before redistribution?

A

Approximately 30 minutes
Must administer isotonic crystalloids alongside to treat the dehydration that the hypertonic saline produces.

83
Q

What can be done to assist challenging vascular access?

A

Elastic wrap - peripheral oedema
Warm towel - venous distension
Tough skin - relief whole
Catheter flushing with NaCl
Ultrasound guided

84
Q

When is venous cutdown for IV catheter placement indicated?

A

Hypovolaemia
Small veins
Obscured veins (obesity, oedema, harnatoma)

85
Q

What are the three approaches for venous access?

A

Percutaneous - direct
Percutaneous facilitative (small skin defect)
Surgical cut down

86
Q

When a CVC is to be utilised, what should be assessed prior to placement?

A

ACT
PT/aPTT

87
Q

What are the contraindications for IO catheterisation?

A

Fractures
Osteomyelitis
Osteosarcoma

88
Q

Name the peripheral sites for arterial catheterisation?

A

Dorsal pedal artery
Radial artery
Auricular artery
Femoral artery
Brachial artery

89
Q

IO catheters can be placed in which sites?

A

Humeral head
Flat medial surface of the proximal tibia
The trochanter is fossa of the femur

90
Q

Name the complications of IO catheter placement

A

Extravasation
Fracture
Osteomyelitis
cellulitis
Fat embolism

91
Q

IO catheters are contraindicated in what species and which bone?

A

Pneumatic bones in avians

92
Q

When using the saphenous vein for CVC, where is the catheter advanced to?

A

Caudal vena cava

93
Q

When using the jugular vein for CVC, where is the catheter inserted to?

A

Superior vena cava

94
Q

Name 5 sites for arterial catheterisation.

A

Dorsal pedal artery
Femoral artery
Auricular artery
Radial artery
Coccygeal artery

95
Q

Name the Resuscitation endpoints.

A

Improved HRT/Pulses/CRT
Improved mentation
Normotension
Blood work - lactate normalisation

96
Q

Isotonic crystalloids for shock resuscitation are administered at…

A

10/20 ml/kg/15-30 minutes

97
Q

Synthetic colloids for shock resuscitation are administered at…

A

1-5ml/kg over 10/30 minutes

98
Q

Hypertonic solutions for shock resuscitation are administered at…

A

3-5ml/kg over 20-30 minutes of 7%~7.5% NaCl

99
Q

pRBCs and FFP for shock resuscitation are administered at…

A

10-20ml/kg over 2-4 hours

100
Q

Fresh whole blood for shock resuscitation are administered at…

A

20-30ml/kg over 2-4 hours

101
Q

Albumin is typically reserved for patients with what conditions?

A

Hypoalbuminemia - secondary to sepsis, septic shock, trauma.

102
Q

When fresh while blood is not available, what ratio is FFP and pRBCs administered?

A

1:1

103
Q

In rapidly decompensating patients, blood transfusions may be administered faster at what rate?

A

1.5ml/kg/min over 15-20 minutes

104
Q

Severe anaphylaxis may lead to?

A

Multi-organ deregulation
DIC

105
Q

What is a biphasic anaphylaxis?

A

Relapse

106
Q

Name the suggested treatment for anaphylaxis.

A

O2 therapy - resp compromise
IV access
IVFT - Hypovolaemia
Epinephrine - vasoconstriction, reduce mucosal oedema
Diphenhydramine - antihistamine
Dexamethasone
Albuterol, terbutaline - bronchodilation

107
Q

Name the six physical examination parameters to assess perfusion.

A

HRT
pulse quality,
MBC
CRT
Peripheral temperature
Mentation

108
Q

Haemorrhagic shock can result in lethal triad, what three conditions are associated with this?

A

Coagulopathy
Acidosis
Hypothermia

109
Q

With massive transfusion, what may happen to the ionised calcium and magnesium?

A

Ionised hypocalceamia
Hypomagnesemia

110
Q

Which type of shock has a decreased circulating blood volume?

A

Hypovolaemic

111
Q

What type of shock has a marked decrease or increase in systemic vascular resistance or maldistribution of blood?

A

Distributive

112
Q

What type of shock has a decrease in forward flow from the heart?

A

Cardiogenic

113
Q

What toe of shock has reduced diastolic filling and preload?

A

Obstructive

114
Q

In sepsis, what indicates septic shock?

A

Persistent hypotension requiring vasopressors

115
Q

What causes primary hypothermia?

A

Excessive exposure to low environmental temperatures.

116
Q

What causes secondary hypothermia?

A

Disease, trauma, surgery, drug induced alteration in thermoregulation.

VTS ECC Caroline (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions