A/27

Question 1

What is shock?

Answer 1

Systemic hypoperfusion

Question 2

What are causes of shock? (3)

Answer 2

• reduced CO
• reduced circulatory blood volume
• dilation of the peripheral vascular structure

Question 3

Consequences of shock

Answer 3

• early : reversible cell injury

- late : necrosis

Question 4

Results of shock (3)

Answer 4

• hypotension
• impaired tissue perfusion
• cellular hypoxia

Question 5

Types of shock (5)

Answer 5

• cardiogenic shock
• hypovolemic shock
• anaphylactic shock
• neurogenic shock
• septic shock

Question 6

Causes of cardiogenic shock

Answer 6

• failure of cardiac pump
• outflow obstruction
• diastolic failure

Question 7

What type of sensitive reaction is anaphylactic shock?

Answer 7

type 1 hypersensitivity reaction

Question 8

What is neurogenic shock?

Answer 8

loss of vascular tone due to spinal cord injury

Question 9

What is septic shock?

Answer 9

immune response to endotoxin of microbe

Question 10

Steps of pathogenesis of septic shock

Answer 10

• endothelial damage
• metabolic defect
• glucocorticoid level increase

Question 11

What causes endothelial damage in septic shock? (4)

Answer 11

• PAMPs bind macrophage/monocyte system
• Binding releases cytokines
• Cytokines activate and cause injury to endothelial cells
• results are thrombosis, vasodilation, vascular permability

Question 12

What is the metabolic defect?

Answer 12

Insulin secretion decrease and insulin resistance of tissues cause hyperglycemia

Question 13

What does hyperglycemia cause in sepis? (2)

Answer 13

• decreased bactericid activity

- accelerated sepsis

Question 14

Morphology of septic shock (5)

Answer 14

• multiorgan failure
• lipid depletion of adrenal cortex
• acute tubular necrosis
• mucosal hemorrhage and necrosis of GI
• diffuse alveolar damage in the lung

Question 15

What causes lipid depletion of cells in the adrenal cortex in septic shock?

Answer 15

increased steroid synthesis