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Which of the following is NOT a common cause of nonresponsive shock?
Which of the following is NOT a common cause of nonresponsive shock?
What is a major risk associated with animals suffering from shock?
What is a major risk associated with animals suffering from shock?
Which monitoring parameter is most indicative of oxygen delivery and utilization?
Which monitoring parameter is most indicative of oxygen delivery and utilization?
What should be monitored to ensure that treated animals do not slip back into shock?
What should be monitored to ensure that treated animals do not slip back into shock?
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What is a common factor that may contribute to shock beyond inadequate volume replacement?
What is a common factor that may contribute to shock beyond inadequate volume replacement?
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Why should smaller aliquots of fluids be administered more slowly to a cat during rewarming?
Why should smaller aliquots of fluids be administered more slowly to a cat during rewarming?
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When are antibiotics indicated in shock treatment?
When are antibiotics indicated in shock treatment?
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What is the primary goal of shock therapy?
What is the primary goal of shock therapy?
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What condition would justify the use of corticosteroids in shock treatment?
What condition would justify the use of corticosteroids in shock treatment?
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Which of the following is NOT an endpoint of shock resuscitation?
Which of the following is NOT an endpoint of shock resuscitation?
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If endpoints are not achieved with fluid therapy, what should be done next?
If endpoints are not achieved with fluid therapy, what should be done next?
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What is a key indicator of effective circulating fluid volume during shock therapy?
What is a key indicator of effective circulating fluid volume during shock therapy?
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What should be monitored to determine the success of shock resuscitation?
What should be monitored to determine the success of shock resuscitation?
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What is a common cause of cardiogenic shock related to the heart's function?
What is a common cause of cardiogenic shock related to the heart's function?
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Which condition is associated with obstructive shock due to impaired cardiac filling?
Which condition is associated with obstructive shock due to impaired cardiac filling?
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What type of shock may occur due to hypoxemia?
What type of shock may occur due to hypoxemia?
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During which stage of shock is the patient most likely able to meet their metabolic oxygen demands?
During which stage of shock is the patient most likely able to meet their metabolic oxygen demands?
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What clinical sign might indicate a patient is experiencing compensatory shock?
What clinical sign might indicate a patient is experiencing compensatory shock?
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Which of the following factors is NOT typically associated with metabolic shock?
Which of the following factors is NOT typically associated with metabolic shock?
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What underlying problem can occur when there is increased oxygen demand exceeding delivery in sepsis?
What underlying problem can occur when there is increased oxygen demand exceeding delivery in sepsis?
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Which of the following is a potential cause of obstructive shock?
Which of the following is a potential cause of obstructive shock?
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Which clinical sign is commonly observed in early decompensatory shock but may present differently in different species?
Which clinical sign is commonly observed in early decompensatory shock but may present differently in different species?
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What is a notable clinical sign of late decompensatory shock?
What is a notable clinical sign of late decompensatory shock?
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In septic shock, which clinical sign is distinctly observed compared to other shocks?
In septic shock, which clinical sign is distinctly observed compared to other shocks?
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What physiological response occurs in the body due to a decrease in pressure detected by aortic baroreceptors?
What physiological response occurs in the body due to a decrease in pressure detected by aortic baroreceptors?
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Which of the following is a consequence of reduced oxygen delivery to non-vital organs during shock?
Which of the following is a consequence of reduced oxygen delivery to non-vital organs during shock?
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What may result from poor perfusion of the intestinal tract during shock?
What may result from poor perfusion of the intestinal tract during shock?
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What is a potential outcome when the body fails to maintain normal compensatory mechanisms in shock?
What is a potential outcome when the body fails to maintain normal compensatory mechanisms in shock?
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What is the primary purpose of administering crystalloids in conjunction with colloids?
What is the primary purpose of administering crystalloids in conjunction with colloids?
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Which of the following is NOT typically associated with shock in animals?
Which of the following is NOT typically associated with shock in animals?
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What is a requirement before administering sympathomimetics to a patient?
What is a requirement before administering sympathomimetics to a patient?
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Which of the following drugs is considered a positive inotropic agent?
Which of the following drugs is considered a positive inotropic agent?
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In cases of cardiogenic shock with myocardial failure, which type of drug may be utilized?
In cases of cardiogenic shock with myocardial failure, which type of drug may be utilized?
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What specific treatment is recommended for animals in shock due to anemia?
What specific treatment is recommended for animals in shock due to anemia?
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What is a potential effect of hypothermia in cats concerning catecholamines?
What is a potential effect of hypothermia in cats concerning catecholamines?
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Which treatment approach is primarily aimed at correcting the underlying cause of metabolic shock?
Which treatment approach is primarily aimed at correcting the underlying cause of metabolic shock?
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The use of which sympathomimetic is intended to increase systemic vascular resistance?
The use of which sympathomimetic is intended to increase systemic vascular resistance?
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What defines shock in a clinical setting?
What defines shock in a clinical setting?
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Which of the following is a category of shock?
Which of the following is a category of shock?
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What is a primary cause of hypovolemic shock?
What is a primary cause of hypovolemic shock?
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Which type of shock is characterized by vasodilation and a state of relative hypovolemia?
Which type of shock is characterized by vasodilation and a state of relative hypovolemia?
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In cardiogenic shock, what is primarily reduced?
In cardiogenic shock, what is primarily reduced?
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What contributes to septic shock?
What contributes to septic shock?
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Which mechanism contributes to energy deprivation in shock?
Which mechanism contributes to energy deprivation in shock?
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Which option correctly describes the effects of vasodilation in distributive shock?
Which option correctly describes the effects of vasodilation in distributive shock?
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Study Notes
Shock Definition and Categories
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Shock is inadequate cellular energy production, arising from insufficient oxygen or nutrient delivery to cells.
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This cellular energy shortfall results in dysfunction and potential cell death at the tissue and organ level.
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Shock categories include:
- Hypovolemic: Low effective circulating blood volume, due to factors like hemorrhage, fluid loss from vomiting, diarrhea, polyurea, or third space fluid shifts (e.g., burns).
- Distributive: Relative hypovolemia due to vasodilation, influenced by anaphylaxis, mast cell tumors, toxins, or neurologic issues (e.g., brain injury, spinal cord injury). Septic shock is a subtype.
- Cardiogenic: Insufficient cardiac output (inadequate blood flow) due to heart-related issues including (but not limited to) myocardial depressant factors, poor contracility, reduced preload and decreased heart rate.
- Obstructive: Physical obstruction impeding blood flow, affecting central circulation (e.g., pericardial effusion, thromboembolic disease, GDV, or colonic torsion).
- Metabolic: Inadequate delivery of substrates to meet energy needs, due to factors like severe anemia, hypoxemia, increased oxygen demand (sepsis, heat stroke), or inability to use oxygen properly (cyanide poisoning).
Shock Stages and Signs
- Shock stages include compensatory, early decompensatory, and late decompensatory (terminal). Each stage is accompanied by unique clinical signs.
- Compensatory shock: compensatory mechanisms like increase heart rate and vasoconstriction are maintained, with normal or slightly elevated blood pressure and pulse quality. Animals often have increased respirations.
- Early decompensatory shock: compensatory mechanisms fail, and signs of reduced blood flow like tachycardia, pale mm, prolonged CRT and low blood pressure are apparent, but not necessarily profound.
- Late decompensatory shock (terminal shock): vital organs, including the heart and brain, begin to show signs of damage due to lack of adequate perfusion and lack of sufficient oxygen. The affected animal is close to death.
Shock Treatment Principles
- Treatment focuses on restoring oxygen delivery and improving circulating volume.
- Fluid therapy is often initial treatment, using isotonic crystalloids or colloids to quickly increase blood volume and improve cardiac output.
- Oxygen therapy is a component of shock resuscitation and is implemented whenever possible to address hypoxia.
- Additional treatment often includes correcting underlying causes (e.g., hemorrhage, infection, or arrhythmia) and or supportive therapies like antimicrobials, pressors, or inotropes.
Shock-Related Activity and Endpoints
- A triage examination of the animal is crucial and should include neurological function, mentation, respirations (rate and pattern), cardiovascular function (color, CRT, pulse quality and rhythm). Urinary assessments (e.g., urine output) are important indicators of adequate blood flow.
- Endpoints of shock resuscitation include normalization of clinical parameters in the animal (e.g., normal colour and CRT, normal blood pressure, heart rate and respirations, adequate urine production)
Monitoring
- Continuous monitoring is important, even after apparent stabilization . - Look for signs of adequate organ perfusion, and signs of cell/organ dysfunction (which can take some time to show).
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Description
Explore the critical concepts of shock, its definitions, and various categories including hypovolemic, distributive, cardiogenic, and obstructive shock. Understand how these conditions affect cellular energy production and the implications for tissue and organ health.
