TCRN Review - Special Situations (Shock,
Psychosocial Issues Related to Trauma, SIRS &
MODS) Exam QUESTIONS AND ANSWERS 100%
RATED CORRECT WITH 100% SURE
PASS|GRADED A+
Describe the process of Obstructive Shock. - CORRECT ANSWERS Myocardium contracts
against high afterload -> Sympathetic over activity leads to vasoconstriction in order to maintain BP ->
Despite normal BP, organs are poorly perfused due to a reduction in blood flow -> Back pressure leads
to venous congestion
List the 4 Classifications of Shock - CORRECT ANSWERS Hypovolemic
Distributive
Cardiogenic
Obstructive
Describe hypovolemic shock - CORRECT ANSWERS Lack of Volume
Describe distributive shock - CORRECT ANSWERS Mal-distribution of blood (vasodilation)
Describe cardiogenic shock - CORRECT ANSWERS Inadequate cardiac output
Describe obstructive shock - CORRECT ANSWERS Inability of blood to enter or exit the heart
adequately
What is another name for early hypovolemic shock? - CORRECT ANSWERS Compensatory
Shock
,The adrenergic system is active during the _____ phase of shock. - CORRECT ANSWERS
Compensatory
The _____ system is active after the phase of shock has passed to bring the body back to a state of
homeostasis. - CORRECT ANSWERS Cholinergic
Another name for the sympathetic system is _____. - CORRECT ANSWERS Adrenergic system
Another name for the parasympathetic system is _____. - CORRECT ANSWERS Cholinergic
system
What is the name of the process in which glycogen stores in the liver are broken down into glucose? -
CORRECT ANSWERS Glycogeonolysis
What is the process in which glucose in the serum is converted to glycogen for storage in the liver? -
CORRECT ANSWERS Glyconeogenesis
What is the term for the speed at which electricity moves through the heart? - CORRECT ANSWERS
Automaticity
What is the role of alpha receptors in the adrenergic (sympathetic) system? - CORRECT ANSWERS
Vasoconstriction, Glycogeonolysis, Diaphoresis
What is the role of the alpha receptors in the cholinergic (parasympathetic) system? - CORRECT
ANSWERS Vasodilation, Glyconeogenesis, Dry Skin
Sympathetic vs. Parasympathetic is also known as what? - CORRECT ANSWERS Fight or
Flight; respectively
,What is the role of Beta-One receptors in the adrenergic (sympathetic) system? - CORRECT ANSWERS
Increased: heart rate, contractility, automaticity
What is the role of Beta-One receptors in the cholinergic (parasympathetic) system? - CORRECT
ANSWERS Decreased: heart rate, contractility, automaticity
What is the role of Beta-Two receptors in the adrenergic (sympathetic) system? - CORRECT ANSWERS
Increased respiratory rate
Bronchodilation
What is the role of Beta-Two receptors in the cholinergic (parasympathetic) system? - CORRECT
ANSWERS Decreased respiratory rate
Bronchoconstriction
What is another term for late shock? - CORRECT ANSWERS Decompensated shock
What occurs during late or decompensated shock? - CORRECT ANSWERS Activation of the
inflammatory system
During late or decompensated shock and the activation of the inflammatory system, what do
inflammatory mediators cause? (3 things) - CORRECT ANSWERS Vasodilation
Increased capillary permeability
Increased coagulation
What are the signs of early or compensated hypovolemic shock? (8 signs/symptoms) - CORRECT
ANSWERS Deceptively normal or slightly elevated blood pressure
Narrowing Pulse Pressure
Tachycardia (weak and thready)
, Tachypnea (deep and rapid)
Normal serum lactate levels
Cool and clammy skin
CNS: anxious and restless
Decreased urinary output
What are the signs of late or decompensated hypovolemic shock? (7 signs/symptoms) - CORRECT
ANSWERS Decreased blood pressure
Tachycardia (may not be palpable peripherally)
Tachypnea (shallow and rapid)
Serum Lactate > 2-4 mmol/L
Cool, clammy and mottled skin
CNS: loss of consciousness
Anuria
What is the average blood volume of an adult? - CORRECT ANSWERS 4700-5500 ml
What is the average blood loss of a thoracic injury? - CORRECT ANSWERS 2000 ml
What is the average blood loss of an intra-abdominal injury? - CORRECT ANSWERS 2000 ml
What is the average blood loss of a tibial fracture? - CORRECT ANSWERS 650 ml
What is the average blood loss of a femur fracture? - CORRECT ANSWERS 1000 ml
What is the average blood loss of a pelvic fracture? - CORRECT ANSWERS 3000 ml
Psychosocial Issues Related to Trauma, SIRS &
MODS) Exam QUESTIONS AND ANSWERS 100%
RATED CORRECT WITH 100% SURE
PASS|GRADED A+
Describe the process of Obstructive Shock. - CORRECT ANSWERS Myocardium contracts
against high afterload -> Sympathetic over activity leads to vasoconstriction in order to maintain BP ->
Despite normal BP, organs are poorly perfused due to a reduction in blood flow -> Back pressure leads
to venous congestion
List the 4 Classifications of Shock - CORRECT ANSWERS Hypovolemic
Distributive
Cardiogenic
Obstructive
Describe hypovolemic shock - CORRECT ANSWERS Lack of Volume
Describe distributive shock - CORRECT ANSWERS Mal-distribution of blood (vasodilation)
Describe cardiogenic shock - CORRECT ANSWERS Inadequate cardiac output
Describe obstructive shock - CORRECT ANSWERS Inability of blood to enter or exit the heart
adequately
What is another name for early hypovolemic shock? - CORRECT ANSWERS Compensatory
Shock
,The adrenergic system is active during the _____ phase of shock. - CORRECT ANSWERS
Compensatory
The _____ system is active after the phase of shock has passed to bring the body back to a state of
homeostasis. - CORRECT ANSWERS Cholinergic
Another name for the sympathetic system is _____. - CORRECT ANSWERS Adrenergic system
Another name for the parasympathetic system is _____. - CORRECT ANSWERS Cholinergic
system
What is the name of the process in which glycogen stores in the liver are broken down into glucose? -
CORRECT ANSWERS Glycogeonolysis
What is the process in which glucose in the serum is converted to glycogen for storage in the liver? -
CORRECT ANSWERS Glyconeogenesis
What is the term for the speed at which electricity moves through the heart? - CORRECT ANSWERS
Automaticity
What is the role of alpha receptors in the adrenergic (sympathetic) system? - CORRECT ANSWERS
Vasoconstriction, Glycogeonolysis, Diaphoresis
What is the role of the alpha receptors in the cholinergic (parasympathetic) system? - CORRECT
ANSWERS Vasodilation, Glyconeogenesis, Dry Skin
Sympathetic vs. Parasympathetic is also known as what? - CORRECT ANSWERS Fight or
Flight; respectively
,What is the role of Beta-One receptors in the adrenergic (sympathetic) system? - CORRECT ANSWERS
Increased: heart rate, contractility, automaticity
What is the role of Beta-One receptors in the cholinergic (parasympathetic) system? - CORRECT
ANSWERS Decreased: heart rate, contractility, automaticity
What is the role of Beta-Two receptors in the adrenergic (sympathetic) system? - CORRECT ANSWERS
Increased respiratory rate
Bronchodilation
What is the role of Beta-Two receptors in the cholinergic (parasympathetic) system? - CORRECT
ANSWERS Decreased respiratory rate
Bronchoconstriction
What is another term for late shock? - CORRECT ANSWERS Decompensated shock
What occurs during late or decompensated shock? - CORRECT ANSWERS Activation of the
inflammatory system
During late or decompensated shock and the activation of the inflammatory system, what do
inflammatory mediators cause? (3 things) - CORRECT ANSWERS Vasodilation
Increased capillary permeability
Increased coagulation
What are the signs of early or compensated hypovolemic shock? (8 signs/symptoms) - CORRECT
ANSWERS Deceptively normal or slightly elevated blood pressure
Narrowing Pulse Pressure
Tachycardia (weak and thready)
, Tachypnea (deep and rapid)
Normal serum lactate levels
Cool and clammy skin
CNS: anxious and restless
Decreased urinary output
What are the signs of late or decompensated hypovolemic shock? (7 signs/symptoms) - CORRECT
ANSWERS Decreased blood pressure
Tachycardia (may not be palpable peripherally)
Tachypnea (shallow and rapid)
Serum Lactate > 2-4 mmol/L
Cool, clammy and mottled skin
CNS: loss of consciousness
Anuria
What is the average blood volume of an adult? - CORRECT ANSWERS 4700-5500 ml
What is the average blood loss of a thoracic injury? - CORRECT ANSWERS 2000 ml
What is the average blood loss of an intra-abdominal injury? - CORRECT ANSWERS 2000 ml
What is the average blood loss of a tibial fracture? - CORRECT ANSWERS 650 ml
What is the average blood loss of a femur fracture? - CORRECT ANSWERS 1000 ml
What is the average blood loss of a pelvic fracture? - CORRECT ANSWERS 3000 ml
