Physiology of Muscle Breakdown and Shock

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Questions and Answers

What is a likely cause of Hg's symptoms, given his heart rate and distended neck veins?

Acute myocardial infarction

Pericardial tamponade (correct)

Hypertension

Pulmonary embolism

Which of the following is a possible consequence of delaying treatment for Hg's condition?

Decreased heart rate

Cardiac arrest (correct)

Increased blood pressure

Improved cardiac function

What is the primary function of the treatment option listed as 'B. Subxiphoid pericardiotomy'?

To increase blood volume

To strengthen the heart muscle

To relieve pressure on the heart (correct)

To regulate heart rate

Why might administering Ringer's lactate solution be considered in Hg's case?

To increase blood pressure (C) Signup and view all the answers

Which of the following is NOT a typical symptom of pericardial tamponade?

Bradycardia (C) Signup and view all the answers

What percentage of body weight does the plasma volume represent?

10% (D) Signup and view all the answers

If an individual weighs 70 kg, what is the approximate volume of their extracellular fluid?

28 L (B) Signup and view all the answers

Which cation is primarily found in the intracellular fluid?

Potassium (B) Signup and view all the answers

What is the approximate volume of plasma in an individual with 20 L of extracellular fluid?

5 L (B) Signup and view all the answers

Which of the following statements regarding extracellular fluid is TRUE?

Extracellular fluid includes plasma and interstitial fluid. (C) Signup and view all the answers

What is the primary purpose of the testing described in the content?

To detect a wide range of bleeding disorders (D) Signup and view all the answers

Which of these statements is TRUE about glucose production in the context of wound healing?

Glucose production increases to provide fuel for healing processes. (B) Signup and view all the answers

For which patients are studies of platelet aggregation specifically recommended?

Patients suspected of having qualitative platelet function defects (D) Signup and view all the answers

In addition to wound healing, which other tissues are mentioned as utilizing glucose?

Nerve tissue and renal medulla (C) Signup and view all the answers

What does the information suggest about the limitations of the described testing?

It may not identify all possible causes of perioperative bleeding (C) Signup and view all the answers

What is the primary function of glucose in wound healing?

To provide energy for the repair and regeneration of tissues (D) Signup and view all the answers

Which of the following is NOT a consequence of increased glucose production during wound healing?

Improved tissue oxygenation (C) Signup and view all the answers

Which of the following is NOT mentioned as a potential cause of perioperative bleeding?

Underlying medical conditions (D) Signup and view all the answers

What type of bleeding disorder is specifically mentioned as a reason to perform platelet aggregation studies?

von Willebrand's disease (A) Signup and view all the answers

What is the significance of the renal medulla utilizing glucose?

To filter waste products from the blood (A) Signup and view all the answers

Which of the following is NOT specifically mentioned as a crucial step in handling specimens and blood products?

Storage (A) Signup and view all the answers

What does the content suggest is the most common outcome of mishandling specimens or blood products?

Allergic reactions (C) Signup and view all the answers

Based on the information provided, what is the severity of reactions due to mishandling specimens or blood products?

Potentially fatal but usually less severe (C) Signup and view all the answers

What is the primary purpose of emphasizing careful handling of specimens and blood products?

To minimize the risk of adverse reactions (D) Signup and view all the answers

What is the main implication of the statement "Allergic and other reactions are common but rarely fatal"?

Mishaps are frequent, but serious consequences are uncommon. (B) Signup and view all the answers

What is the recommended course of action for patients scheduled for a major surgical procedure?

All of the above. (D) Signup and view all the answers

What is the primary purpose of a history and physical examination in the context of bleeding problems?

To identify potential risk factors for bleeding. (D) Signup and view all the answers

Which of the following laboratory tests is NOT commonly used to assess bleeding risk in patients scheduled for major surgery?

Liver Function Test (LFT) (A) Signup and view all the answers

What is the significance of performing a Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) test on patients scheduled for major surgery?

To evaluate the coagulation cascade and clotting factors. (D) Signup and view all the answers

What is the most likely outcome if a patient with a bleeding problem undergoes a major surgical procedure without proper assessment and management?

Increased risk of excessive bleeding during and after surgery. (B) Signup and view all the answers

Study Notes

Skeletal Muscle Breakdown

Skeletal muscle breakdown primarily releases alanine and glutamine
Alanine is converted to glucose in the liver
Glutamine is involved in renal acid-base balance and cellular fuel

Glucose Production

Post-operative or post-traumatic glucose is used by the central nervous system, kidney, and healing tissues
Skeletal muscle primarily uses fatty acids
Bone primarily uses mineral substrates

Shock Definition

Shock is best defined as hypoperfusion of tissues
Hypoperfusion leads to tissue hypoxia (potential cause of hypoxemia)
Hypotension is a late indicator of shock

Neurogenic Shock

Neurogenic shock results from severe head injury, spinal cord injury, or high spinal anesthesia
These injuries cause sympathetic denervation, leading to vasodilation (arteriolar and venous) and increased venous capacitance
Characteristics include warm and dry extremities, tachycardia (sometimes bradycardia), and hypotension.
Volume replacement is typically the primary treatment

Cardiogenic Shock Treatment

Dobutamine, sodium nitroprusside, and Intra-aortic balloon pump (IABP) are useful in treatment
Pneumatic antishock garment (PASG) is not useful

Hemorrhagic Shock

Hemorrhagic shock causes an initial interstitial fluid contraction
The use of colloid solutions or hypertonic saline is not contraindicated and may be useful.
Decreased pulse pressure is an early indicator of hemorrhagic shock.

CNS Injury & Hyponatremia

Signs of increased intracranial pressure may be masked by hyponatremia
Hyponatremia may lead to oliguric renal failure
Rapid correction of hyponatremia may prevent central pontine myelinolysis

Extracellular Fluid

Extracellular fluid accounts for 20% of body weight.
Plasma volume is roughly 5% of total body weight
Sodium is the major cation in extracellular fluid

Bleeding Disorders

Acquired bleeding disorders are more frequent than congenital
Vitamin K deficiency reduces factors II, VII, IX, X, protein C, and protein S
Hypothermia can also disrupt platelet function, causing bleeding problems

Transfusion Reactions

Clerical errors are the most common cause of fatal transfusion reactions
ABO-incompatible transfusions are a primary danger of clerical error

Nutritional Support

The goal is maintaining body cell mass and preventing weight loss greater than 10%
Early nutritional support is crucial, prior to significant weight loss, in trauma patients to promote host defence mechanism

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Description

This quiz explores the physiological aspects of skeletal muscle breakdown, glucose production, and the definition and characteristics of shock. Understand how skeletal muscles release amino acids and the implications of shock on tissue perfusion. Dive into neurogenic shock and its causes for a comprehensive overview.