Block 5 - Quiz 8 Content| Top Scores Made Simple | Trusted Test Solutions!

BLOCK 5 - QUIZ 8 CONTENT| TOP SCORES MADE SIMPLE
| TRUSTED TEST SOLUTIONS!
Shock Answer: Systemic circulatory insufficiency that results in widespread tissue
hypoperfusion

- Leads to widespread hypoxia. Lack of oxygen results in mitochondrial dysfunction and
lack of ATP

Systemic circulatory insufficiency that results in widespread tissue hypoperfusion
Answer: Shock

Consequences of shock Answer: Tissue hypoperfusion leads to widespread hypoxia ->
Lack of oxygen results in mitochondrial dysfunction and lack of ATP

Shock effect on ATP Answer: Shift from oxidative to anaerobic glucose metabolism
means that only 2 molecules of ATP are produced per 1 molecule of glucose vs. 36
molecules of ATP from 1 molecule of glucose through oxidative phosphorylation

Gross findings in shock Answer: End organ damage

- Shock causes cell swelling and death

Which one of the following most likely indicates worsening

tissue perfusion in a patient in shock? Please choose a

single answer.
A. Hypo- or hyper-natremia
B. Lactic acidosis

C. Ketosis

D. Lipolysis Answer: B. Lactic acidosis

Lactic acidosis Answer: Caused by accumulation of lactic acid in tissues and
extracellular fluid

- Caused by hypoxemia

Caused by accumulation of lactic acid in tissues and extracellular fluid

- Caused by hypoxemia Answer: Lactic acidosis
4 categories of shock Answer: - Hypovolemic

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,- Cardiogenic

- Obstructive

- Distributive

Hypovolemic shock Answer: Shock resulting from blood or fluid loss
Shock resulting from blood or fluid loss Answer: Hypovolemic shock

Cardiogenic shock Answer: Shock caused by inadequate function of the heart, or pump
failure
- LV failure

Shock caused by inadequate function of the heart, or pump failure

- LV failure Answer: Cardiogenic shock

Distributive shock Answer: A condition that occurs when there is widespread dilation of
the small arterioles, small venules, or both

- Redistribution of extracellular fluid

A condition that occurs when there is widespread dilation of the small arterioles, small
venules, or both

- Redistribution of extracellular fluid Answer: Distributive shock

What shock results from a "true" hypovolemia Answer: Hypovolemic shock

What shock results from redistribution of extracellular fluid and a "relative" hypovolemia
Answer: Distributive shock

Obstructive shock Answer: Shock that occurs when there is a block to blood flow in the
heart or great vessels, causing an insufficient blood supply to the body's tissues.

Shock that occurs when there is a block to blood flow in the heart or great vessels,
causing an insufficient blood supply to the body's tissues. Answer: Obstructive shock

Excessive bleeding can cause what type of shock Answer: Hypovolemic shock

MI can cause what type of shock? Answer: Cardiogenic shock

Pulmonary embolism can cause what type of shock? Answer: Obstructive shock
Anaphylaxis can cause what type of shock? Answer: Distributive shock

15% blood loss Answer: ~ 750 ml
What is the lowest level of blood loss

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,that may lead to hypovolemic shock?

A. 15%

B. 25%

C. 30% Answer: A. 15%
30% blood loss Answer: ~ 1500 ml

Hypovolemia affect on preload Answer: Decreases preload

- Decreased volume -> Decreased preload

Hypovolemia affect on contractility Answer: Causes an initial compensatory increase in
myocardial contractility as part of the body's response to maintain blood pressure and
circulation

Hypovolemia affect on stroke volume and cardiac output Answer: Decreases stroke
volume and cardiac output
- Decrease in preload -> Decrease in SV -> Decrease in CO

Compensatory mechanisms for shock Answer: - Restore and maintain tissue perfusion

- Restore and maintain blood pressure

- Restore and maintain volume

What is a major challenge to restoring and maintaining blood pressure in hypovolemic
shock? Answer: Hypovolemia decreases cardiac output due to decreased SV -> Blood
pressure decreases

Hypovolemia affect on heart rate Answer: Tachycardia
Signs and symptoms of hypovolemic shock Answer: - Tachycardia

- Pale, clammy skin

- Thirst

- Oliguria
- Tachypnea

- Tachycardia

- Pale, clammy skin

- Thirst
- Oliguria

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, - Tachypnea

Signs and symptoms of? Answer: Hypovolemic shock

48-yr-old man with stab wound to abdomen.

• Prehospital vital signs include blood pressure (BP) 82/53, pulse 90,
respiratory rate 16

• PE: smiling and talking; single abdominal stab wound to right

lower quadrant; assessment: wound exploration identified

violation of anterior fascia, but not of underlying muscle;

• Plan — move to ED observation unit;

• Patient discharged after 12 hr of observation; vital signs at

discharge included BP 107/67, pulse 98, respiratory rate 18, and

temperature 100.4 °F'
Diagnosis? Answer: Hypovolemic shock

Hypocolemic shock diagnostic criteria Answer: 1. Ill appearance or altered mental
status

2. Heart rate > 100 beats/min

3. Respiratory rate > 20 breaths/min or Pa CO2 < 32 mm Hg

4. Arterial base deficit < 4 mEq/L or lactate level > 4 mM/L

5. Urine output < 0.5 mL/kg/h
6. Arterial hypotension > 30 min duration, continuous

1. Ill appearance or altered mental status
2. Heart rate > 100 beats/min

3. Respiratory rate > 20 breaths/min or Pa CO2 < 32 mm Hg

4. Arterial base deficit < 4 mEq/L or lactate level > 4 mM/L

5. Urine output < 0.5 mL/kg/h

6. Arterial hypotension > 30 min duration, continuous Answer: Diagnostic criteria for
hypovolemic shock
Causes of cardiogenic shock Answer: - Myocardial infarction

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