SHOCK Flashcards Preview

D&T 1 Exam 1 > SHOCK > Flashcards

Flashcards in SHOCK Deck (13):
1

Cardiogenic Shock

dec CO due to pump failure

2

Hypovolemic Shock

dec CO due to loss of circulating volume

3

Anaphylactic Shock

widespread vasodilation and INC vascular permeability from IgE hypersensitivity RXN

4

Neurogenic Shock

Following anesthetic accident, acute brain, or spinal cord injury
Neural control of vasomotor tone is lost resulting in generalized vasodilation

5

Systemic Inflammatory Response Syndrome (SIRS)

Exaggerated and systemic manifestation of a LOCAL inflammatory reaction -- often fatal

6

Diagnosing SIRS

2 or more signs of systemic inflammation:
1. Fever
2. Tachycardia
3. Tachypnea
4. Leukocytosis or Leukopenia

Temp: > 100.4 or 90
RR >20
WBC >12,000 or

7

Sepsis

SIRS with a culture-proven infection or obvious infection

8

Septic shock

clinical SIRS severe enough to lead to HYPOTENSION and ORGAN DYSFUNCTION

9

Number 1 cause of death in ICU

Septic Shock

10

Inflammatory mediators of Septic Shock

1. TLRs -- recognize and trigger start of sepsis
2. TNF, IL-1, IGN-gamma; IL-12, IL-18 (PRO INFLAMMATORY)
3. Prostaglandins and PAF (PROCOAGULATION)
4. Complement Cascade (HYPERINFLAMMATION)

11

Endothelial cell activation and injury has 3 consequences

1. Thrombosis (DIC)
2. Inc Vascular Permeability (3rd SPACING) -- tissue hypoperfusion and stasis
3. Vasodilation - NO

12

Stages of Shock

1. Nonprogressive Phase - reflex mechanisms compensate and tissue perfusion is maintained (SIRS)
2. Progressive - tissue hypoperfusion; worsening circulatory and metabolic imbalances -- acidosis
3. Irreversible -- extensive cellular and tissue injury (DEATH)

13

Treatment of Septic Shock

Antibiotics for infection
Fluid resuscitation and vasopressor drugs
Insulin therapy for hyperglycemia
Corticosteroids (HIGH)
Anti-inflammatory treatments