BCCCP- Shock Syndromes and Sepsis A C T U A L E X A M 2 0 2 6
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EXAM QUESTIONS AND CORRECT ANSWERS
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What two biochemical lab values do we see in
shock? Why do we see them?
hyperlactatemia (greater than 2 mmol/L): stems from pyruvate
formed from lactate dehydrogenase after glycolysis as body
switches to anaerobic metabolism
reduced Svo2 (less than 70%)
(usually indicates abnormal cellular 02 metabolism)
Hemodynamic normal values
,What can decrease the intrinsic contractility of the myocardium?
sepsis
myocardial ischemia
cardiomyopathy
What is the correlation between preload and afterload in
regards to stroke volume?
Pre-load proportionally related
to SV (preload increases= SV
increases)
Afterload is inversely related to
SV (Afterload increases=SV
decreases)
What is one of the biggest determinants of LV afterload?
SVR (aka Total peripheral resistance): if SVR vasoconstricts then
SVR increases.
,How can you quickly approximate if a pt has decreased or
increased SVR?
Skin temperature
warm skin suggests decreased SVR
(vasodilation) cold skin suggests increased
SVR (vasoconstriction).
Shock state chart
normal values: (learn these) CVP: 0 - 5 mm
PCWP: 2-14 mmHg
CO: 4.7 L (5 quarts) of blood per minute SVR: 700-1,500
dynes/seconds/cm
, What organ clears lactate?
in who do we see extreme elevations when in
shock? Liver metabolizes lactate back to
pyruvate.
Pts with severe liver dysfunction = decrease clearance=
accentuates buildup.
What is Scvo2 and Svo2?
what do these values tell
us?
Scvo2: catheter tip ends @ superior vena cava.
more reflective of oxygen extraction in the brain and upper body
than is systemic.
Svo2: represents systemic oxygen extraction
Mixes venous blood from the superior vena cava, inferior vena
cava (IVC), and coronary sinus.
What does a decreased Scvo2 and Svo2 mean?
sign that tissue oxygen demands are not completely met by Do2
|| MOST RECENT EXAM ACTUAL COMPLETE REAL
EXAM QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+ |
GUARANTEED SUCCESS!! NEWEST EXAM | JUST
RELEASED!!
What two biochemical lab values do we see in
shock? Why do we see them?
hyperlactatemia (greater than 2 mmol/L): stems from pyruvate
formed from lactate dehydrogenase after glycolysis as body
switches to anaerobic metabolism
reduced Svo2 (less than 70%)
(usually indicates abnormal cellular 02 metabolism)
Hemodynamic normal values
,What can decrease the intrinsic contractility of the myocardium?
sepsis
myocardial ischemia
cardiomyopathy
What is the correlation between preload and afterload in
regards to stroke volume?
Pre-load proportionally related
to SV (preload increases= SV
increases)
Afterload is inversely related to
SV (Afterload increases=SV
decreases)
What is one of the biggest determinants of LV afterload?
SVR (aka Total peripheral resistance): if SVR vasoconstricts then
SVR increases.
,How can you quickly approximate if a pt has decreased or
increased SVR?
Skin temperature
warm skin suggests decreased SVR
(vasodilation) cold skin suggests increased
SVR (vasoconstriction).
Shock state chart
normal values: (learn these) CVP: 0 - 5 mm
PCWP: 2-14 mmHg
CO: 4.7 L (5 quarts) of blood per minute SVR: 700-1,500
dynes/seconds/cm
, What organ clears lactate?
in who do we see extreme elevations when in
shock? Liver metabolizes lactate back to
pyruvate.
Pts with severe liver dysfunction = decrease clearance=
accentuates buildup.
What is Scvo2 and Svo2?
what do these values tell
us?
Scvo2: catheter tip ends @ superior vena cava.
more reflective of oxygen extraction in the brain and upper body
than is systemic.
Svo2: represents systemic oxygen extraction
Mixes venous blood from the superior vena cava, inferior vena
cava (IVC), and coronary sinus.
What does a decreased Scvo2 and Svo2 mean?
sign that tissue oxygen demands are not completely met by Do2
