SHOCK/MODS/SIRS-DIC |COMPLETE STUDY GUIDE WITH
100% ACCURATE QUESTIONS & ANSWERS | ACE EVERY
TEST | GUARANTEED EXCELLENCE.
What is shock? Answer: -Inadequate delivery of oxygen and nutrients to peripheral tissue
bed (body's cells)
-Decreased blood flow (perfusion) to body tissues results in cellular hypoxia which causes
organ failure, leads to MODS--> Death
What does MODS stand for? Answer: multiple organ dysfunction syndrome
What does decreased delivery of oxygen and nutrients lead to? Answer: Impaired cell
metabolism
In the absence of oxygen, what do cells do? Answer: Anaerobic metabolism
What is the byproduct of anaerobic metabolism? Answer: lactic acid
What does a buildup of lactic acid cause? Answer: Tissue acidosis (metabolic) - pH drops
What does tissue acidosis lead to? Answer: Organ dysfunction
What is the problem in obstructive shock? Answer: Obstruction to blood flow or pumping
of heart
What are the causes of obstructive shock? Answer: -Cardiac tamponade (heart is
squeezed and can't pump)
-Pulmonary embolism (right side of heart can't pump against)
-Tension pneumothorax (air can't escape, pushes mediastinum over, heart is squeezed and
can't pump)
What is the perfusion triangle? Answer: -Contractility (pump)
-Afterload (container function)
,-Preload (Content function)
What are the stages of shock? Answer: -Initial
-Compensatory
-Progressive
-Refractory
What happens during the initial stage of shock? Answer: -CO decreased
-Tissue perfusion threatened
-Lactic acid rises (normal <1), over 4 would be an uh-oh
What can you find during initial stage of shock? Answer: Look for signs of decreased
perfusion
What happens during the compensatory stage of shock? Answer: Reversible
-SNS (neural, hormonal, biochemical) activated
What neural compensatory mechanisms kick in during the compensatory stage of shock?
Answer: -Increase epi/norepi
-Increase HR, SVR, contractility, vasoconstriction
-Shunt blood to heart and brain (vital organs)
What hormonal compensatory mechanisms kick in during the compensatory stage of
shock? Answer: -RAAS (release of renin, hold on to more sodium and water)
-Adrenals (glucocorticoids make blood sugar rises, epi, norepi)
What is the first organ system to shut down? Answer: GI tract (bowel sounds diminished,
high residuals on tube feed)
What happens if we don't treat and reverse shock early? Answer: Compensatory
mechanisms shut down - they can't work forever
, What happens during the progressive stage of shock? Answer: Failed compensation
-Drop in CO - decreased perfusion
-Lactic acid levels continue to rise
-Increased vascular permeability --> proteins leak --> intravascular hypovolemia and tissue
edema
-Cell death
What happens during refactory stage of shock? Answer: Irreversible and Unmanageable
-Further decline
-MODS (2+ systems fail)
-All organs shut down
-Death (no recovery)
What is SIRS? Answer: Systemic inflammatory response syndrome
What causes SIRS? Answer: Insult (any type of shock, trauma, brain injury, burn,
pacreatitis) - cytokines are released
What happens when cytokines are released? (coagulation cascade) Answer: Vessels get
leaky (increased vascular permeability)
What happens after increased vascular permeabiltiy? (coagulation cascade) Answer:
Plasma leaks into interstitial space --> coagulation process stimulated
What happens whent the coagulation process is stimulated? (coagulation cascade)
Answer: Platelets attract WBCs and clump, fibrin clots form that obstruct blood flow
What happens after obstruction of blood flow? (coagulation cascade) Answer: WBC,
platelets, endothelial cells release more vasodilating substances (NO, histamine,
bradykinin) --> more capillary leak
100% ACCURATE QUESTIONS & ANSWERS | ACE EVERY
TEST | GUARANTEED EXCELLENCE.
What is shock? Answer: -Inadequate delivery of oxygen and nutrients to peripheral tissue
bed (body's cells)
-Decreased blood flow (perfusion) to body tissues results in cellular hypoxia which causes
organ failure, leads to MODS--> Death
What does MODS stand for? Answer: multiple organ dysfunction syndrome
What does decreased delivery of oxygen and nutrients lead to? Answer: Impaired cell
metabolism
In the absence of oxygen, what do cells do? Answer: Anaerobic metabolism
What is the byproduct of anaerobic metabolism? Answer: lactic acid
What does a buildup of lactic acid cause? Answer: Tissue acidosis (metabolic) - pH drops
What does tissue acidosis lead to? Answer: Organ dysfunction
What is the problem in obstructive shock? Answer: Obstruction to blood flow or pumping
of heart
What are the causes of obstructive shock? Answer: -Cardiac tamponade (heart is
squeezed and can't pump)
-Pulmonary embolism (right side of heart can't pump against)
-Tension pneumothorax (air can't escape, pushes mediastinum over, heart is squeezed and
can't pump)
What is the perfusion triangle? Answer: -Contractility (pump)
-Afterload (container function)
,-Preload (Content function)
What are the stages of shock? Answer: -Initial
-Compensatory
-Progressive
-Refractory
What happens during the initial stage of shock? Answer: -CO decreased
-Tissue perfusion threatened
-Lactic acid rises (normal <1), over 4 would be an uh-oh
What can you find during initial stage of shock? Answer: Look for signs of decreased
perfusion
What happens during the compensatory stage of shock? Answer: Reversible
-SNS (neural, hormonal, biochemical) activated
What neural compensatory mechanisms kick in during the compensatory stage of shock?
Answer: -Increase epi/norepi
-Increase HR, SVR, contractility, vasoconstriction
-Shunt blood to heart and brain (vital organs)
What hormonal compensatory mechanisms kick in during the compensatory stage of
shock? Answer: -RAAS (release of renin, hold on to more sodium and water)
-Adrenals (glucocorticoids make blood sugar rises, epi, norepi)
What is the first organ system to shut down? Answer: GI tract (bowel sounds diminished,
high residuals on tube feed)
What happens if we don't treat and reverse shock early? Answer: Compensatory
mechanisms shut down - they can't work forever
, What happens during the progressive stage of shock? Answer: Failed compensation
-Drop in CO - decreased perfusion
-Lactic acid levels continue to rise
-Increased vascular permeability --> proteins leak --> intravascular hypovolemia and tissue
edema
-Cell death
What happens during refactory stage of shock? Answer: Irreversible and Unmanageable
-Further decline
-MODS (2+ systems fail)
-All organs shut down
-Death (no recovery)
What is SIRS? Answer: Systemic inflammatory response syndrome
What causes SIRS? Answer: Insult (any type of shock, trauma, brain injury, burn,
pacreatitis) - cytokines are released
What happens when cytokines are released? (coagulation cascade) Answer: Vessels get
leaky (increased vascular permeability)
What happens after increased vascular permeabiltiy? (coagulation cascade) Answer:
Plasma leaks into interstitial space --> coagulation process stimulated
What happens whent the coagulation process is stimulated? (coagulation cascade)
Answer: Platelets attract WBCs and clump, fibrin clots form that obstruct blood flow
What happens after obstruction of blood flow? (coagulation cascade) Answer: WBC,
platelets, endothelial cells release more vasodilating substances (NO, histamine,
bradykinin) --> more capillary leak
