50 Questions
What is the peak concentration hypothesis related to?
Continuous renal replacement therapy in sepsis
Which article discusses the evolving rationale for early enteral nutrition?
The Evolving rationale for early enteral nutrition based on paradigms of multiple organ failure: a personal journey
Which study is associated with intensive insulin therapy in critically ill patients?
Intensive insulin therapy and mortality in critically ill patients
Which article compares intensive versus conventional glucose control in critically ill patients?
Intensive versus conventional glucose control in critically ill patients
What is the focus of the article by Ortiz Leyba et al.?
Specialized nutritional and metabolic support in the critically-ill patient
Which article delves into translational research in sepsis?
Translational research in sepsis— an ultimate challenge
What is the main cause of hypotension in cases of gastric dilation/volvulus?
Obstruction of the vena cava
What is the primary pathogenesis of hypotension in pericardial effusion with cardiac tamponade?
Right atrial collapse and failure of right-sided filling
Which condition can cause obstructive shock by twisting the stomach itself?
Gastric dilation/volvulus
What is the primary cause of hypotension associated with valvular disease?
Decreased contractility
What is the common mechanism of hypotension in diseases causing a decrease in systemic vascular resistance?
Increased arterial vasodilation
What is the potential cause of cardiogenic hypotension associated with severe mitral regurgitation?
Reduction in effective stroke volume
In patients with SIRS/sepsis, what results in an increase in cardiac output and a hyperdynamic state during the early stages?
Afterload reduction brought about by arterial vasodilation
What is the primary cause of decreased cardiac output and hypotension associated with tachyarrhythmias?
Decreased cardiac contractility
What is the potential cause of hypotension through systemic release of vasoactive substances in anaphylaxis?
Vasodilation
What is the potential cause of decreased venous return and further contributes to cardiovascular collapse in patients with SIRS/sepsis?
Systemic vasodilation
What is another example of reduced systemic vascular resistance through systemic release of vasoactive substances?
Severe acidosis
What is the main cause of hypotension associated with secondary myocardial dysfunction?
Systemic inflammatory response syndrome/sepsis
What is the preferred method for measuring MAP values in dogs and cats to assess hypotension?
Direct blood pressure monitoring
Which of the following clinical signs reflect peripheral vasoconstriction or impaired perfusion in patients?
Altered mentation and cool distal extremities
In dogs and cats, hypotension could be considered when the MAP is below which value?
80 mm Hg
What are the potential complications from catheter placement during direct blood pressure monitoring in critically ill dogs?
Bleeding, infection, thrombosis
Which method of blood pressure measurement is generally less invasive, less expensive, and more readily available compared to direct methods?
Indirect blood pressure measurement
What is the preferred method for measuring blood pressure in critically ill or hypotensive dogs?
Direct blood pressure monitoring
Which clinical sign reflects the reduction in systemic vascular resistance (SVR) and increase in peripheral perfusion in patients in the early stages of vasodilatory shock?
Bounding pulses and red mucous membranes
Which patient demographic is direct blood pressure monitoring less commonly used in, except for temporary monitoring during anesthesia?
Cats
What are the limitations of indirect methods of blood pressure measurement compared to direct measurement?
Overestimates blood pressure in hypotension, underestimates in hypertension
Which clinical signs may develop before a decrease in blood pressure, especially during compensation?
Tachycardia and weak peripheral pulses
What should be recognized before diagnosing hypotension based on MAP values in dogs and cats?
The limitations of the methods used for blood pressure measurement
Which method of blood pressure measurement is generally less technically challenging compared to direct methods?
Indirect blood pressure measurement
What is the main moment-to-moment regulator of blood pressure?
Baroreceptor reflex system
What triggers the release of histamines and leukotrines that promote vasodilation and increased vascular permeability?
IgE
Which reflex originates in chemoreceptor organs and responds to a decrease in tissue oxygen tension, increase in carbon dioxide, or decrease in pH?
Chemoreceptor reflex
What promotes vasoconstriction by triggering vascular smooth muscle contraction and stimulating sympathetic activity?
Angiotensin II
What plays a major role in expanding blood volume by promoting sodium and water retention in the proximal tubule?
Angiotensin II
What causes vasoconstriction and an increase in systemic vascular resistance through activation of V1 receptors?
Vasopressin
What is the immediate response to a decrease in blood pressure due to disruption of sympathetic outflow?
Increased venous tone
Which system responds to decreased baroreceptor activity, sympathetic activation, or decreased tubular chloride as sensed by the macula densa?
RAA system
What promotes sodium reabsorption and potassium excretion in the cortical collecting duct?
Aldosterone
Which hormone primarily regulates vasopressin (ADH) release based on changes in blood osmolarity?
Vasopressin
Which factor primarily determines mean arterial pressure (MAP)?
Heart rate and stroke volume
What primarily affects systemic vascular resistance (SVR) and thereby determines MAP?
Systemic mediators and local factors
What is the primary contributor to cardiac output (CO)?
Heart rate and stroke volume
What mainly dictates heart rate, the other major contributor to cardiac output (CO)?
Relative balance between SNS and PNS
Which of the following is a vasoconstrictive agent primarily responsible for basal systemic vascular tone?
Endothelin
What is directly related to preload and contractility, whereas it is inversely related to afterload?
Stroke volume
Which of the following substances can serve to affect blood flow in response to changes in metabolic demand, muscle activity, and vascular injury?
Histamine and prostaglandins
What primarily determines mean arterial pressure (MAP) in a closed system?
Flow (cardiac output [CO]) and resistance (systemic vascular resistance [SVR])
What condition results from a reduction in systemic arterial blood pressure?
Hypotension
What primarily affects tissue perfusion by exerting force against the vessel wall?
Arterial blood pressure
Learn about the causes of relative hypovolemia and preload reduction, including venodilation and its impact on venous return. Understand how major obstruction in venous return can lead to preload reduction and the potential for hypotension to develop.
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