Questions and Answers
What is the primary goal of the metabolic response to injury?
Which phase of the response to trauma is characterized by hypovolemia and decreased cardiac output?
What complication can arise due to an abnormal metabolic response to injury?
What triggers the Flow Phase after the EBB Phase during the response to trauma?
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Which hormone is NOT typically associated with the metabolic response to injury?
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Which of the following statements on the concept of homeostasis is true?
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What is a characteristic of the Systemic Inflammatory Response Syndrome (SIRS)?
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What leads to multiple organ dysfunction syndrome (MODS) during the metabolic response to injury?
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Which condition is characterized by increased cardiac output and raised body temperature?
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What is a potential consequence of the inflammatory-type process in SIRS?
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What does the metabolic response to injury aim to minimize through enhanced recovery after surgery?
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Which of the following factors is NOT associated with the metabolic response to injury?
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What role does modern surgical care aim to fulfill in response to injury?
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Which strategy is part of the enhanced recovery after surgery (ERAS) program?
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What percentage of mortality is associated with MODS in surgical patients?
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Which of the following describes a consequence of fat and protein mobilization in SIRS?
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Study Notes
Metabolic Response to Injury
- Injury triggers pathways involving hormones, inflammatory cytokines, and neural circuits.
- Alters body metabolism, wound healing, immunity, and specific organ functions.
- Collectively known as the metabolic response to injury, aimed at limiting damage and promoting repair.
Complications from Injury Response
- Metabolic responses can lead to complications such as sepsis.
- Sepsis can prolong abnormal processes and result in multiple organ dysfunction syndrome (MODS).
- Effective management of injury response enhances patient outcomes, crucial in modern preoperative care, especially after major surgeries.
Homeostasis and Organ Dysfunction
- Homeostasis refers to maintaining a constant internal environment for optimal cellular function.
- Surgery or injury can disrupt homeostasis, leading to organ dysfunction.
Phases of Trauma Response
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Initial (EBB) phase lasts approximately 24-48 hours after injury:
- Characterized by hypovolemia and decreased basal metabolic rate.
- Decreased cardiac output, hypothermia, and lactic acidosis are observed.
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Following resuscitation, EBB phase transitions to the hypermetabolic FLOW phase:
- Corresponds to systemic inflammatory response syndrome (SIRS).
- Mobilizes energy stores for tissue repair, driven by pro-inflammatory cytokines (e.g., Interleukin 1, Interleukin 6, Tumor Necrosis Factor (TNF)).
Characteristics of SIRS
- SIRS features include:
- Tissue edema due to vasodilation and increased capillary leak.
- Elevated basal metabolic rate (hypercatabolism) and cardiac output.
- Increased body temperature and leukocytosis.
- Raised oxygen consumption and gluconeogenesis.
- Significant fat and protein mobilization occurs, especially from peripheral tissues to central tissues like the liver and immune system, resulting in weight loss and higher urinary nitrogen excretion.
Importance of Surgical Care
- Modern surgical care aims to align with the body’s injury responses for effective recovery.
- Systemic effects of injury crucially impact survival rates; deaths can occur days post-injury due to complex physiological processes.
Impacts of Injury Response
- Alongside catabolic effects, inflammatory processes lead to immune suppression.
- This predisposes patients to sepsis and MODS, a leading cause of death in surgical patients, with mortality around 25%.
Enhanced Surgical Recovery Strategies
- Modern practices aim to minimize homeostasis demands, reducing primary injury impact:
- Minimal access surgeries (e.g., laparoscopic) lower surgical injury magnitude.
- Limit fasting duration, ensure pain control, and promote early mobilization to enhance recovery.
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Description
This quiz explores the complex metabolic responses to injury, highlighting the roles of hormones, inflammation-related cytokines, and neural circuits. Understand how these factors influence metabolism, wound healing, and organ function. Discover the potential complications that can arise, including sepsis.
