3.2.1 Hypotension Flashcards

1
Q

What are the three clasifications of shock?

A

Hypovolemic

Distributive

Cardiogenic

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2
Q

What are some examples of hypovolemic?

A

Hemorrhage, Dehydration, Burns, Excessive Fluid Loss

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3
Q

What are some examples of distributive shock?

A

Septic, Anaphylactic, Neurogenic

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4
Q

What are some examples of cardiogenic shock?

A

Cardiac tamponade, heart failure, MI

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5
Q

What are the the two common results of shock?

A

Decreased MAP and impaired organ blood flow

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6
Q

What is the main problem in each type of shock?

A

Hypovolemic: Low blood volume

Distributive: arteriolar problem

Cardiogenic: pump problem

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7
Q

Describe the systemic effects/concept map of hypovolemic shock.

A
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8
Q

How can you distinguish hypovolemic shock due to hemorrhage from dehydration? How do you treat both of these?

A

Hemorrhage: Isotonic contraction (plasma osmolality is nearly normal), blood

Dehydration: Hypertonic contraction (plasma osmolality is greater than normal), 5% dextrose

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9
Q

During hemorrhagic shock, the person’s pulse would have been described as weak or thready. What is the significance of this finding?

A
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10
Q

How much blood can be lost before aterial pressure changes? CO? What is responsibl for the difference b/t the two values?

A

Arterial pressure begins to change after 30% of blood is lost.

CO begins to change after 20% of blood is lost.

The difference is due to the baroreflex. The baroreflex can stimulate arteriolar contraction which will act to sustain MAP as long as possible.

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11
Q

What are all of the factors that alter and adjust SV in hemorrhagic shock?

A
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12
Q

Describe the mechanism that leads to septic shock, a form of distributive shock.

A
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13
Q

What happens to the rate of runoff in distributive shock?

A

Increased!!!

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14
Q

What allows for the extravasation of leukocytes from post-capillary venules despite the increased production of NO in septic shock? (This results in increased vascular permeability and edema)

A

Pro-inflammatory factors outweigh high levels of NO

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15
Q

Describe the mechanism leading to decreased MAP in anaphylactic shock.

A
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16
Q

Why is eprinephrine used in the acute treatment of anaphylactic shock rather than norepinephrine?

A

It’s effects on both alpha-1 receptors as well as relax airways via beta-2 receptors

17
Q

Describe the mechanism leading to decreased MAP in neurogenic shock.

A
18
Q

Describe the mechanism/concept map leading to cardiac tamponade.

A
19
Q

What curve utilized in P-V loops is affected by cardiac tamponade?

A

Passive filling curve will be shifted upwards and EDV decreased

20
Q

What would be the major change in a person’s ECG recording after development of cardiac tamponade?

A

Diminish amplitude of waves and reduce heart sounds

21
Q

What are the compensatory responses to shock?

A
22
Q

What are the effects of SYM activation of Beta-1 receptors? Alpha-1 receptors?

A

Beta-1: Increase HR and SV (increased inotropic state)

Alpha-1: arteriolar constriction (increased TPR) and venoconstriction (increased venous return)

23
Q

What are the intial problems, compensatory responses, and secondary complications in the three types of shock?

A
24
Q

What is the main way to differentiate b/t hemorrhagic shock and cardiogenic shock?

A

Hemorrhagic shock: Decreased CVP

Cardiogenic shock: Increased CVP

25
Q

What are the treatments for each of the types of shock?

A
26
Q

What is irreversible shock?

A
27
Q

What are some of the mechanisms that lead to irreversible shock?

A
28
Q
A
29
Q
A

D. Impaired blood flow to systemic organs

30
Q
A

A

31
Q
A

D

32
Q
A

D

33
Q
A

E

34
Q
A

E

35
Q
A