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Questions and Answers
Which of the following is NOT a cause of hypovolemic shock?
Which of the following is NOT a cause of hypovolemic shock?
Hypovolemic shock can be caused by a loss of whole blood, plasma, or extracellular fluid.
Hypovolemic shock can be caused by a loss of whole blood, plasma, or extracellular fluid.
True (A)
What is the primary physiological characteristic of hypovolemic shock?
What is the primary physiological characteristic of hypovolemic shock?
Diminished blood volume
Hypovolemic shock is caused by a ______ in blood volume leading to decreased filling of the circulatory system.
Hypovolemic shock is caused by a ______ in blood volume leading to decreased filling of the circulatory system.
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Match the following causes of fluid loss to their respective categories in hypovolemic shock:
Match the following causes of fluid loss to their respective categories in hypovolemic shock:
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What is one of the key goals in the treatment of cardiogenic shock?
What is one of the key goals in the treatment of cardiogenic shock?
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Fluid therapy is not a component of cardiogenic shock treatment.
Fluid therapy is not a component of cardiogenic shock treatment.
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Name one cause of obstructive shock.
Name one cause of obstructive shock.
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Distributive shock occurs when blood volume is abnormally displaced in the __________ away from the heart.
Distributive shock occurs when blood volume is abnormally displaced in the __________ away from the heart.
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Which of the following is NOT a type of distributive shock?
Which of the following is NOT a type of distributive shock?
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Match the type of shock with its cause:
Match the type of shock with its cause:
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Cyanosis of the lips and skin can be a symptom of cardiogenic shock.
Cyanosis of the lips and skin can be a symptom of cardiogenic shock.
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What type of monitoring is important in the management of cardiogenic shock?
What type of monitoring is important in the management of cardiogenic shock?
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What is a common cause of septic shock?
What is a common cause of septic shock?
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Anaphylactic shock can lead to angioedema.
Anaphylactic shock can lead to angioedema.
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Name one medication used in the treatment of anaphylactic shock.
Name one medication used in the treatment of anaphylactic shock.
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Septic shock leads to inadequate perfusion, oxygenation, and ______ to tissues.
Septic shock leads to inadequate perfusion, oxygenation, and ______ to tissues.
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Match the symptoms of anaphylactic shock with their descriptions:
Match the symptoms of anaphylactic shock with their descriptions:
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What characterizes the 'Warm Phase' of septic shock?
What characterizes the 'Warm Phase' of septic shock?
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In septic shock, the prognosis indicates that 28-50% of patients may die.
In septic shock, the prognosis indicates that 28-50% of patients may die.
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Identify one preventive measure for septic shock.
Identify one preventive measure for septic shock.
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The body's attempt to maintain a stable internal environment is known as ______.
The body's attempt to maintain a stable internal environment is known as ______.
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Etiologic factors are the direct causes of a disease or illness.
Etiologic factors are the direct causes of a disease or illness.
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What is the primary consequence of inadequate blood flow to tissues?
What is the primary consequence of inadequate blood flow to tissues?
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Which of the following is a major component of the pathophysiology framework used in the study of disease?
Which of the following is a major component of the pathophysiology framework used in the study of disease?
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Match the following terms with their correct definitions:
Match the following terms with their correct definitions:
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What is the end result of the renin-angiotensin-aldosterone system (RAAS)?
What is the end result of the renin-angiotensin-aldosterone system (RAAS)?
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When the sympathetic nervous system is activated, it releases norepinephrine.
When the sympathetic nervous system is activated, it releases norepinephrine.
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Which of the following is NOT a consequence of inadequate blood flow to tissues?
Which of the following is NOT a consequence of inadequate blood flow to tissues?
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What is a primary characteristic of neurogenic shock?
What is a primary characteristic of neurogenic shock?
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Bradycardia is a key symptom of neurogenic shock.
Bradycardia is a key symptom of neurogenic shock.
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Name two common triggers of anaphylactic shock.
Name two common triggers of anaphylactic shock.
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Hypotension in neurogenic shock is primarily due to ______.
Hypotension in neurogenic shock is primarily due to ______.
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Match the following symptoms with their corresponding shock type:
Match the following symptoms with their corresponding shock type:
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Which treatment is NOT recommended for neurogenic shock?
Which treatment is NOT recommended for neurogenic shock?
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Neurogenic shock can last for several weeks after its onset.
Neurogenic shock can last for several weeks after its onset.
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What physiological mechanism contributes to the symptoms of anaphylactic shock?
What physiological mechanism contributes to the symptoms of anaphylactic shock?
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What are the two key mechanisms used to maintain blood pressure (BP) and cardiac output (CO) in shock?
What are the two key mechanisms used to maintain blood pressure (BP) and cardiac output (CO) in shock?
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The ______ mechanism involves the release of renin, angiotensin, and aldosterone.
The ______ mechanism involves the release of renin, angiotensin, and aldosterone.
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What is the primary role of the sympathetic nervous system (SNS) in shock?
What is the primary role of the sympathetic nervous system (SNS) in shock?
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Over time, compensation mechanisms in shock can lead to further deterioration.
Over time, compensation mechanisms in shock can lead to further deterioration.
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In the ______ stage of shock, compensation mechanisms are unable to keep up, leading to worsening hypoperfusion and cell damage.
In the ______ stage of shock, compensation mechanisms are unable to keep up, leading to worsening hypoperfusion and cell damage.
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Match the following stages of shock with their corresponding characteristics:
Match the following stages of shock with their corresponding characteristics:
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What are three of the most important compensatory mechanisms in shock?
What are three of the most important compensatory mechanisms in shock?
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What is the key characteristic that distinguishes the irreversible stage of shock from the other stages?
What is the key characteristic that distinguishes the irreversible stage of shock from the other stages?
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Flashcards
Etiology
Etiology
The study of the cause or origin of a disease.
Risk Factors
Risk Factors
Characteristics or conditions that increase the likelihood of developing a disease.
Cardiac Output (CO)
Cardiac Output (CO)
The volume of blood the heart pumps per minute.
Mean Arterial Pressure (MAP)
Mean Arterial Pressure (MAP)
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Systemic Vascular Resistance (SVR)
Systemic Vascular Resistance (SVR)
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Circulatory Failure (Shock)
Circulatory Failure (Shock)
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Aerobic vs Anaerobic Metabolism
Aerobic vs Anaerobic Metabolism
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Na-K Pump Impairment
Na-K Pump Impairment
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Prognosis in Shock
Prognosis in Shock
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Types of Shock
Types of Shock
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Hypovolemic Shock
Hypovolemic Shock
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Causes of Hypovolemic Shock
Causes of Hypovolemic Shock
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Compensatory Mechanisms
Compensatory Mechanisms
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Cardiogenic Shock Symptoms
Cardiogenic Shock Symptoms
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Goals of Cardiogenic Shock Treatment
Goals of Cardiogenic Shock Treatment
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Vasoactive Medications
Vasoactive Medications
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Mechanical Assistive Devices
Mechanical Assistive Devices
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Obstructive Shock Causes
Obstructive Shock Causes
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Right Sided Heart Failure Symptoms
Right Sided Heart Failure Symptoms
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Distributive Shock
Distributive Shock
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Types of Distributive Shock
Types of Distributive Shock
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Sympathetic Nervous System (SNS)
Sympathetic Nervous System (SNS)
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Renin-Angiotensin-Aldosterone Mechanism (RAA)
Renin-Angiotensin-Aldosterone Mechanism (RAA)
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Stages of Shock
Stages of Shock
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Compensatory Stage Effects
Compensatory Stage Effects
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Progressive Stage Effects
Progressive Stage Effects
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Irreversible Stage Effects
Irreversible Stage Effects
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Hypoperfusion
Hypoperfusion
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Septic Shock
Septic Shock
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Neurogenic Shock
Neurogenic Shock
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Key Symptoms of Neurogenic Shock
Key Symptoms of Neurogenic Shock
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Hypotension in Neurogenic Shock
Hypotension in Neurogenic Shock
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Treatment for Neurogenic Shock
Treatment for Neurogenic Shock
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Anaphylactic Shock
Anaphylactic Shock
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Histamine Release in Anaphylaxis
Histamine Release in Anaphylaxis
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Common Triggers of Anaphylactic Shock
Common Triggers of Anaphylactic Shock
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Anaphylactic Shock Symptoms
Anaphylactic Shock Symptoms
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Epinephrine in Anaphylaxis
Epinephrine in Anaphylaxis
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Septic Shock Cause
Septic Shock Cause
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High CO Phase in Septic Shock
High CO Phase in Septic Shock
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Cold Phase of Septic Shock
Cold Phase of Septic Shock
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Septic Shock Prognosis
Septic Shock Prognosis
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ABCs in Anaphylactic Treatment
ABCs in Anaphylactic Treatment
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Vasoactive Drugs in Shock
Vasoactive Drugs in Shock
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Study Notes
Pathology & Therapeutics II: Review and Shock - Week 1
- This week's content reviews pathophysiology and shock.
- A pathophysiology framework encompassing etiology, pathological process, and interventions is discussed.
- Review questions focus on cardiac output (CO), mean arterial pressure (MAP), and systemic/peripheral vascular resistance (SVR/PVR).
- The autonomic nervous system and renin-angiotensin-aldosterone system (RAAS) are also reviewed.
- Circulatory failure, also known as shock, is defined as an inadequate tissue perfusion, preventing oxygen and nutrient delivery to vital organs and cells.
- Shock is often a consequence of life-threatening conditions or trauma.
- The body attempts to compensate for this shock through homeostasis.
- Understanding the consequences of inadequate blood flow to tissues is crucial.
Pathophysiology Framework - Review
- Etiology factors include risk factors.
- The pathological process involves the mechanism of disease or illness, with its manifestations and complications.
- Symptoms and signs (S&S), as well as bodily responses, are significant considerations.
- Diagnostic tests and therapeutic interventions are integral components of treatment.
Review
- Cardiac output (CO) is vital to understand.
- Mean arterial pressure (MAP) is a key indicator.
- Systemic/peripheral vascular resistance (SVR/PVR) is also significant.
Review
- Understanding the autonomic nervous system is necessary.
- Identifying the substance released by the stimulated sympathetic nervous system is important.
- The renin-angiotensin-aldosterone system (RAAS) should be understood.
- Understanding the end result of the RAAS is key.
Circulatory Failure (AKA Shock)
- Shock (circulatory failure) is characterized by inadequate tissue perfusion.
- This condition results from life-threatening situations or injuries.
- The body attempts to compensate for inadequate perfusion through homeostasis.
Pathophysiology of Shock - Cellular Level Effects
- Hypoperfusion leads to a change in metabolism from aerobic to anaerobic.
- Adenosine triphosphate (ATP) production is affected, resulting in specific by-products.
- This impacts cellular function as the Na-K pump is disrupted.
- Cellular injury occurs, releasing various substances, potentially leading to cell death.
Pathophysiology of Shock - Compensation Mechanisms
- The goal of compensation mechanisms is to maintain blood pressure (BP) and cardiac output (CO).
- The sympathetic nervous system (SNS) plays a crucial role by regulating heart rate and contractility as well as vascular tone.
- The renin-angiotensin-aldosterone mechanism (RAAS) also contributes to maintaining blood volume and pressure.
- Over time, these compensatory mechanisms can actually contribute to the worsening of shock.
Compensatory Mechanisms in Shock
- Understanding the role of the sympathetic nervous system (SNS) in shock is vital.
- The SNS attempts to maintain blood pressure by increasing heart rate, contractility, and constricting arterioles and venules.
- Other mechanisms, such as the renin-angiotensin-aldosterone system (RAAS), are also engaged to preserve blood volume and pressure.
- Compensation mechanisms attempt to counteract reductions in blood volume and pressure.
Types of Shock (Overview)
- Cardiogenic shock arises from issues with cardiac function.
- Hypovolemic shock results from a decrease in blood volume.
- Obstructive shock is associated with an obstruction impeding blood flow.
- Distributive shock involves inappropriate vasodilation, resulting in various types like anaphylactic, neurogenic, and septic shock.
Hypovolemic Shock
- Hypovolemic shock arises from decreased blood volume, leading to inadequate filling of the circulatory system.
- Causes include loss of whole blood, plasma, and extracellular fluids due to hemorrhage, severe burns, or gastrointestinal (GI) losses.
Pathophysiology of Hypovolemic Shock
- Decreased blood volume leads to decreased venous return.
- This reduction in stroke volume and cardiac output results from decreased blood return.
- The consequences of this decreased blood volume and circulation eventually manifest as poor tissue perfusion.
Identify the Manifestations of Hypovolemic Shock
- Early signs of hypovolemic shock often include tachycardia and decreased blood pressure.
- Late signs typically involve a decreased urine output, cool and clammy skin and altered mental status.
Hypovolemic Shock Treatment
- Treatment focuses on addressing the underlying cause.
- Re-establishing vascular volume with intravenous fluids or blood products is crucial.
- Medications (vasoactive) may be necessary to elevate blood pressure.
- Monitoring, ongoing assessment and positioning are integral to care.
Cardiogenic Shock
- Cardiogenic shock occurs when the heart fails adequately to pump blood.
- Origins can include coronary or non-coronary issues such as myocardial infarction (MI), ineffective pumping (arrhythmias), and post-cardiac surgical complications.
Pathophysiology of Cardiogenic Shock
- Decreased cardiac contractility leads to diminished cardiac output.
- Reduced stroke volume impacts cardiac output, which in turn negatively affects perfusion to tissues.
- Pulmonary congestion and impaired coronary artery perfusion are potential consequences.
Think about it...
- Reduced cardiac output affects blood pressure and can lead to inadequate perfusion despite normal blood volume.
- The sympathetic nervous system (SNS) and renin-angiotensin-aldosterone system (RAAS) respond to these issues.
- Cardiac workload escalation can worsen heart failure, impacting coronary perfusion.
Manifestations of Cardiogenic Shock
- The symptoms often include dysrhythmias and hemodynamic instability including decreased MAP and urine output.
- Other evident features include signs like cyanosis of the extremities and pulmonary edema.
- Changes in level of consciousness can also manifest.
Treatment of Cardiogenic Shock
- Treatment aims to limit myocardial damage and improve cardiac output to increase tissue perfusion, including reducing workload and oxygen demands.
- Important procedures may include managing pain, monitoring hemodynamics, medication (vasoactive) administration, and addressing the cause.
Obstructive Shock
- Obstructive shock occurs due to mechanical impediments in central blood circulation.
- This can occur from conditions such as dissecting aortic aneurysm, cardiac tamponade, pneumothorax, and pulmonary embolism - which is often the most prevalent cause.
- Increased pressure on the right side of the heart leads to decreased blood return to the heart, hindering cardiac output.
Obstructive Shock
- Right-sided heart failure can develop as symptoms manifest.
- Treatment primarily focuses on addressing the underlying cause of the obstruction.
Distributive Shock
- Distributive shock results from abnormal blood distribution away from the central circulation.
- Classifications include neurogenic, anaphylactic, and septic shock.
Pathophysiology of Distributive Shock
- The underlying pathophysiology of all forms of distributive shock involves vasodilation, leading to a maldistribution of blood volume, diminished venous return, and reduced cardiac output.
- Insufficient circulation to important organs negatively affects tissue perfusion.
Neurogenic Shock
- Neurogenic shock results from vasodilation due to loss of sympathetic tone, frequently stemming from spinal cord injuries or spinal anesthesia.
- Key symptoms include bradycardia, hypotension caused by vasodilation, warm flushed skin, and a disruption of the body's temperature regulation.
- Treatment typically involves restoring blood pressure through intravenous fluids combined with vasoactive medications, and also addressing the heart rate through other medical support.
Anaphylactic Shock
- Anaphylactic shock is caused by a severe allergic reaction to an antigen, sometimes even after the initial exposure to that antigen.
- Common triggers include medications, foods, insect venom, and latex.
- The allergic reaction causes a release of histamine, leading to widespread vasodilation and increased capillary permeability, causing issues like hypotension and shock.
- Treatment involves immediate removal of the allergen, addressing the airway, breathing and circulation (ABCs) as well as administered fluids, epinephrine, antihistamines, and corticosteroids.
Anaphylactic Shock Manifestations
- Anxiety, laryngeal edema, bronchospasm, hypotension, tachycardia, itching are possible signs of anaphylactic shock.
- Angioedema and urticaria are significant manifestations, as is abdominal cramping associated with GI or uterine contraction and loss of consciousness in severe cases.
Anaphylactic Shock Treatment
- Immediate removal of the triggering agent is paramount.
- Addressing the ABCs (airway, breathing, circulation) is vital.
- Fluid administration, epinephrine, antihistamines, and corticosteroids are crucial treatments.
- Intubation and oxygen administration might be necessary.
- Proactive measures to prevent further allergic reactions are essential.
Septic Shock
- Septic shock is the most common form of distributive shock, typically caused by gram-negative bacteria, with bacteremia and pneumonia being common precursors.
- Elderly individuals are at higher risk.
Pathophysiology of Septic Shock
- Septic shock starts when microorganisms invade tissues, triggering an immune response.
- This response leads to the massive release of inflammatory mediators such as cytokines, which trigger a systemic inflammatory response.
- The mediators produce increased capillary permeability and vasodilation.
- Tissue perfusion suffers, leading to an inadequate oxygen and nutrient supply.
Septic Shock - 2 Phases
- Septic shock progresses through stages, including a warm phase characterized by high CO, vasodilation, and elevated blood pressure.
- The subsequent cold phase is marked by decreased CO, further vasodilation, and eventually organ failure.
Septic Shock Treatment
- Treatment aims to identify, isolate and treat the underlying cause or infection.
- Fluid replacement is critical for maintaining adequate blood circulation.
- Providing supplemental oxygen may require advanced mechanical ventilation techniques.
- Medications such as antibiotics, vasoactive drugs, and antipyretics may be indicated.
Complications of Shock
- Acute respiratory distress syndrome (ARDS) is a potential shock complication.
- Acute kidney injury (AKI) may occur.
- Gastrointestinal complications are other possible consequences.
- Disseminated intravascular coagulation (DIC) is also a significant risk.
- Multiple organ dysfunction syndrome (MODS) can lead to irreversible damage with prolonged shock.
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Description
This quiz covers key concepts from Pathology & Therapeutics Week 1, focusing on the pathophysiology of shock, cardiac output, and blood circulation. Topics include the autonomic nervous system and the RAAS, highlighting their roles in tissue perfusion and homeostatic responses to shock. Test your understanding of these critical concepts.
