Circulatory Shock Overview

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Questions and Answers

What characterizes nonprogressive shock?

  • There is a complete loss of consciousness.
  • Compensatory mechanisms are inadequate.
  • Compensatory mechanisms are sufficient to prevent further deterioration. (correct)
  • It is marked by irreversible tissue damage.

Which of the following mechanisms is NOT part of the compensatory mechanisms in nonprogressive shock?

  • Formation of vasopressin.
  • Baroreceptor reflexes.
  • Increased capillary permeability. (correct)
  • Stimulation of thirst center.

What is the primary cause of hypovolemic shock?

  • Hemorrhage (correct)
  • Neurogenic factors
  • Cardiac dysfunction
  • Excessive blood volume

In progressive shock, which factor contributes to cardiac depression?

<p>Decreased coronary blood flow. (C)</p> Signup and view all the answers

Which event does NOT occur during the irreversible stage of shock?

<p>Effective compensatory mechanisms. (C)</p> Signup and view all the answers

Which of the following conditions can lead to severe plasma loss, contributing to hypovolemic shock?

<p>Severe burns (B)</p> Signup and view all the answers

What is a result of increased capillary permeability during progressive shock?

<p>Fluid transudation into tissues. (B)</p> Signup and view all the answers

What is the survival rate for individuals who develop cardiogenic shock?

<p>15 percent or less (D)</p> Signup and view all the answers

Which of the following is a primary characteristic of neurogenic shock?

<p>Massive dilation of veins (A)</p> Signup and view all the answers

What detrimental effect on cells occurs during severe shock?

<p>Diminished active transport of sodium and potassium. (B)</p> Signup and view all the answers

Which phenomenon contributes to the blockage of very small vessels in progressive shock?

<p>Increased acidity of the blood. (C)</p> Signup and view all the answers

What physiological response can occur alongside traumatic shock?

<p>Neurogenic shock due to pain (C)</p> Signup and view all the answers

What happens to cellular metabolism in the final stages of shock?

<p>It becomes greatly depressed. (B)</p> Signup and view all the answers

Which of the following statements is true regarding plasma loss and dehydration?

<p>Fluid loss from nephrotic kidneys is a cause of dehydration. (C)</p> Signup and view all the answers

Which type of shock involves an inadequate cardiac pumping function?

<p>Cardiogenic shock (B)</p> Signup and view all the answers

Which of the following is a factor that does NOT contribute to hypovolemic shock?

<p>Deep general anesthesia (D)</p> Signup and view all the answers

What is the primary effect on the liver during the progression of shock?

<p>Depression of metabolic and detoxification functions (A)</p> Signup and view all the answers

In cases of shock caused by hemorrhage, what is generally considered the best type of therapy?

<p>Transfusion of whole blood (A)</p> Signup and view all the answers

Which type of shock is highlighted as treatable with sympathomimetic drugs?

<p>Neurogenic shock (A)</p> Signup and view all the answers

What is a primary benefit of administering oxygen therapy during shock?

<p>Increases oxygen delivery to tissues (C)</p> Signup and view all the answers

What is the recommended position for a patient experiencing hemorrhagic shock?

<p>Head-down position (D)</p> Signup and view all the answers

Which of the following is NOT indicated as a treatment for shock in the provided information?

<p>Intravenous glucose administration (C)</p> Signup and view all the answers

What type of shock is indicated by a neonate admitted with respiratory distress and subsequent deterioration?

<p>Septic shock (C)</p> Signup and view all the answers

Which type of shock would NOT typically result in pulmonary edema?

<p>Hypovolemic shock (D)</p> Signup and view all the answers

What is the primary factor contributing to massive vasodilatation and increased capillary permeability during anaphylactic shock?

<p>Histamine release from mast cells and basophils (C)</p> Signup and view all the answers

Which type of bacteria is predominantly responsible for endotoxin shock?

<p>Gram-negative bacteria (B)</p> Signup and view all the answers

In which stage of shock does the body’s compensatory mechanisms successfully restore normal function without therapeutic intervention?

<p>Nonprogressive stage (A)</p> Signup and view all the answers

What causes septic shock in the context of a bacterial infection?

<p>Widespread bacterial infection damaging organs (D)</p> Signup and view all the answers

Which type of shock is primarily associated with rapid fluid and protein loss into tissue spaces?

<p>Anaphylactic shock (D)</p> Signup and view all the answers

Which event can trigger an anaphylactic shock reaction in a sensitive individual?

<p>Exposure to a previously encountered antigen (A)</p> Signup and view all the answers

What is endotoxin shock most similar to in terms of its physiological effects?

<p>Anaphylactic shock (C)</p> Signup and view all the answers

Which of the following scenarios could lead to hypovolemic shock?

<p>Excessive loss of blood volume (C)</p> Signup and view all the answers

Flashcards

Circulatory Shock

A state where blood flow is insufficient to deliver oxygen and nutrients to tissues, leading to potential cell damage.

Hypovolemic Shock

Circulatory shock caused by a loss of blood volume. This can be due to blood loss (hemorrhage), plasma loss, or both.

Hemorrhagic Shock

Hypovolemic shock due to bleeding.

Hypovolemic Shock (Plasma Loss)

Hypovolemic shock caused by loss of plasma from the bloodstream, even without red blood cell loss.

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Cardiogenic Shock

Circulatory shock arising from a weakened heart's inability to pump blood effectively.

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Neurogenic Shock

Circulatory shock caused by a sudden loss of blood vessel tone, leading to widespread vessel dilation and reduced blood return to the heart.

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Circulatory shock

Loss of blood flow to the tissues due to a reduction in blood's ability to carry oxygen.

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Hypovolemic shock caused by plasma loss

Loss of blood volume due to fluid loss from the body.

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Anaphylactic Shock

A serious condition where the body's blood pressure drops dangerously low due to an allergic reaction, triggered by an antigen-antibody reaction that causes the release of histamine. Rapid vasodilation and increased capillary permeability lead to fluid and protein loss into the tissues.

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Septic Shock

A severe condition characterized by widespread bacterial infection in the bloodstream, leading to extensive tissue damage. It can be triggered by various sources like peritonitis or skin infections.

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Endotoxin Shock

A type of septic shock specifically caused by gram-negative bacteria, primarily colon bacilli. These bacteria release a toxin called endotoxin, which, upon entering the bloodstream, triggers a reaction similar to anaphylaxis.

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Nonprogressive stage of shock

A stage of shock where the body's compensatory mechanisms are still working, and the body can potentially recover without external intervention.

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Progressive stage of shock

This stage of shock occurs when the body's compensatory mechanisms fail, and vital organs start to shut down due to lack of oxygen and nutrients.

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Nonprogressive Shock

A stage of shock where the body's compensatory mechanisms are still working to maintain blood pressure and circulation.

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Progressive Shock

A stage where the body's compensatory mechanisms are failing and shock is getting worse, leading to organ damage.

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Cardiac Depression

A decrease in heart muscle function due to reduced blood flow to the heart, further reducing cardiac output.

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Vasomotor Failure

Blood flow to the brain reduces so much that control of blood vessel dilation and constriction is lost.

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Blockage of Very Small Vessels

Tiny blood clots form in small blood vessels, further blocking blood flow.

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Increased Capillary Permeability

Increased permeability of blood vessels allows fluid to leak out into tissues, reducing blood volume.

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Release of Toxins by Ischemic Tissue

Tissues starved of oxygen and nutrients release harmful substances that worsen shock.

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Generalized Cellular Deterioration

Many cellular processes break down in the body, including the ability to transport nutrients and produce energy.

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Irreversible Shock

A severe medical condition where the body's circulatory system fails to deliver enough oxygenated blood to the tissues, leading to organ damage and potential death.

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Sympathomimetic Drugs

Specialized drugs, such as epinephrine and norepinephrine, that mimic the effects of the sympathetic nervous system, helping to constrict blood vessels and increase heart rate.

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Replacement Therapy

The process of replacing lost fluids and blood components in cases of shock.

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Pulmonary Edema

A condition where the lungs fill with fluid, impairing their ability to function properly.

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Heart Contractility

The ability of the heart to contract and pump blood effectively.

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Venous Return

The process of returning blood from the lower extremities to the heart.

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Study Notes

Circulatory Shock

  • Circulatory shock is inadequate blood flow to tissues, causing damage due to insufficient flow.
  • Shock types are categorized by underlying causes.

Hypovolemic Shock

  • This type of shock involves reduced blood volume.
  • Hemorrhagic shock is a common form, caused by bleeding.
  • Hypovolemia can result from plasma loss, even without red blood cell loss, leading to reduced blood volume.
    • Intestinal obstruction and severe burns can cause significant plasma loss.

Dehydration

  • Causes of dehydration shock include excessive sweating, diarrhea, vomiting, inadequate fluid intake, and kidney issues (nephrotic kidneys).
  • These factors lead to insufficient fluid and electrolyte balance.

Other Types of Shock

  • Traumatic shock: Extensive tissue contusion leads to substantial plasma loss into tissues.
  • Cardiogenic shock: Inadequate cardiac pumping, often after heart attack or prolonged cardiac deterioration, reduces blood flow.
  • Neurogenic shock: Sudden loss of vasomotor tone causes widespread vein dilation, diminished venous return, and decreased cardiac output.
    • Severe cases include general or spinal anaesthesia, or trauma to the brain causing vasomotor depression.
  • Anaphylactic shock: Allergic reaction to an antigen immediately after exposure, triggers an antibody reaction causing mast cells and basophils to rapidly release histamine.
    • This reaction causes significant vasodilation and high capillary permeability that leads to fluid loss.
  • Septic shock: Widespread bacterial infection, causing widespread damage via toxins, can lead to severe shock.

Stages of Shock

  • Nonprogressive (compensated): Compensatory mechanisms effectively prevent further deterioration of circulation.
  • Progressive: Shock worsens without intervention.
  • Irreversible: Therapy is ineffective, and the patient's life is at risk.

Physiology of Treatment (Shock)

  • Replacement therapy: Blood transfusion for hemorrhage, plasma administration for plasma loss, and electrolyte solutions to correct dehydration.

Additional Cellular Effects of Shock

  • Disrupted Cellular Processes: Diminished sodium/potassium transport in cell membranes, mitochondrial dysfunction in liver and other tissues, lysosomal release, and hampered cellular nutrient metabolism (e.g., glucose).
  • These cellular effects contribute to further organ system (e.g. liver, lungs, heart) deterioration.
  • Kidney Damage: Deteriorative lesions can occur in the kidneys, resulting in eventual kidney failure.

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