shock

Question 1

1. Factors involved in the mechanism of reperfusion injury:
   Select one or more:
   a. increased sympathetic tone
   b. tissue hypoxia
   c. endothelial cell damage
   d. activation of the renin-angiotensin-aldosteron system (RAAS

Answer 1

b

Question 2

2. typical for anaphylaxis:
Select one or more:
a. systemic reaction of sepsis
b. triggered by allergic reaction
c. allergen can be food
d. the consequence of vomiting or diarrhea or dehydration

Answer 2

b/c

Question 3

3. Causative factors of hyperdynamic stage in distributive shock:
Select one or more:
a. accumulation of lactic acid
b. increased NO production due to iNOS activity
c. hypothermia
d. accumulation of octopamine
e. severe hypotension
f. Normovolemia
g. decreased TPR
h. increased cardiac output

Answer 3

a/b/d/g/f/g/h

Question 4

4. Type of shock in which in the early phase the pale and sweaty skin is typical?
Select one or more:
a. Septic
b. Hypovolemic
c. Cardiogenic
d. Neurogenic

Answer 4

b/c

Question 5

5. Changes of laboratory parameters observed in shock:
   Select one or more:
   a. decreased serum phenylalanine and tyrosine levels
   b. increased blood urea nitrogen (BUN)
   c. decreased serum lactate level
   d. increased serum alanine and glutamine levels
   e. increased serum fibrinogen level
   f. increased serum glucose level
   g. decreased levels of acute phase proteins
   h. increased serum leu/tyr, leu/phe ratio

Answer 5

a/b/d/e/f/h

Question 6

6. Compensatory mechanisms in shock:
Select one or more:
a. chemoreceptor reflex
b. reabsorption of interstitial fluid
c. baroreceptor reflex
d. immune system activation
e. Reabsorption of tissue fluid
f. Cerebral ischemia

Answer 6

a/b/c/f

Question 7

7. Compensatory mechanisms in shock EXCEPT: ( red because it is a “rare” question”)
   a. immune system activation
   b. baroreceptor reflex
   c. chemoreceptor reflex
   d. cerebral ischemic reflex

Answer 7

a

Question 8

8. Cause(s) of hypovolemic shock:
Select one or more:
a. adrenocortical failure
b. diabetes insipidus
c. acute pancreatitis
d. generalized exfoliative dermatitise. Diarrhea
f. penicillin allergy
g. diabetes mellitus
h. pneumothorax

Answer 8

a/b/c/d/e/g

Question 9

9. Indicative of irreversible phase of shock
Select one or more:
a. gray, cyanotic skin
b. weak, suppressible pulse
c. comatose stage
d. sweating

Answer 9

c

Question 10

10. What is the shock index?
    Select one
    a. pulse rate (bpm) / RRsys (mmHg)
    b. respiratory rate (1/min) / mean arterial pressure (mmHg)
    c. pulse rate (bpm) / mean arterial pressure (mmHg)
    d. respiratory rate (1/min) / RRdias (mmHg

Answer 10

a

Question 11

11. Obstructive shock can be caused by:
Select one or more:
a. Pneumothorax
b. diabetes mellitus
c. heart tamponade
d. pulmonary embolization
e. ventricular fibrillation
f.acute pancreatitis

Answer 11

a/c/d

Question 12

12. Causes of cardiogenic shock:
Select one or more:
a. asthma cardiale
b. excessive burn
c. pericardial tamponade
d. valvular regurgitation or stenosi
e. Addison’s disease
f. severe systemic acidosis
g. pump function failure
h. spinal cord injury

Answer 12

a/c/d/f/g

Question 13

13. Possible causes of the decompensation in the late phase of shock:
Select one or more:
a. metabolic acidosis
b. endothelial injury
c. respiratory alkalosis
d. tachypnea

Answer 13

a/b

Question 14

14. Hypovolemic shock can be caused by:
Select one or more:
a. pulmonary embolism
b. diabetes mellitus
c. acute pancreatitis
d. pneumothorax

Answer 14

b/c

Question 15

15. Clinical signs characteristic to progressive phase of hypovolemic shock :
Select one or more:
a. tissue acidosis
b. decreased capillary filling
c. oliguria/anuria
d. acrocyanosis

Answer 15

a//b/c/d

Question 16

16. Alterations of kidney function in shock:
    Select one or more:
    a. Na+ retention
    b. oliguria/anuria
    c. If RR < 60 mmHg, high chance for tubular necrosis
    d. dec reased concentrating ability
    e. decreased GFR
    f. decreased concentrating ability
    g. polyuria
    h. If RR < 60 mmHg, high risk for glomerular damage

Answer 16

b/d/e//f

Question 17

17. Changes of microcirculation in shock:
    Select one or more:
    a. hemodilution
    b. venoconstriction
    c. arterial/arteriolar vasoconstriction
    d. resistance of post capillary vessels are decreased
    e. edema
    f. hemoconcentration
    g. arterial/arteriolar vasoconstriction
    h. resistance of post capillary vessels are increased

Answer 17

a/b/c/g/h

Question 18

18. Causes of distributive shock:
Select one or more:
a. spinal cord injury
b. allergic reaction triggered by penicillin
c. pulmonary embolism
d. sepsis
e. systemic acidosis caused by poisoning
f. spinal cord injury
g. Addison’s disease
h. chronic heart failure

Answer 18

a/b/d/f/

Question 19

19. Immediate compensatory mechanisms induced by fluid depletion (BP: 90 mmHg):
    Select one or more:
    a. activation of low pressure receptors
    b. activation of the renin-angiotensin system
    c. activation of peripheral chemoreceptors
    d. central nervous system ischemic response

Answer 19

a/c/d

Question 20

20. Clinical signs characteristic to compensated phase of hypovolemic shock:
Select one or more:
a. cold, pale extremities
b. bradycardia
c. tachypnea
d. SBP < 70 mmHg
e. acrocyanosis
f. decreased capillary filling
g. oliguria/anuria
h. tissue acidosi s

Answer 20

a/c/g

Question 21

21. Alterations of bowel function in shock:
    Select one or more:
    a. increased permeability
    b. mesenteric vasoconstriction
    c. increased peristaltic activity
    d. bacteria invade into the blood or lymph

Answer 21

a/b/d

Question 22

22. Characteristic findings in hyperdynamic stage of distributive shock:
Select one or more:
a. severe hypotension
b. normovolemia
c. decreased TPR
d. increased cardiac output

Answer 22

b/c

Question 23

23. Criteria for appropriate tissue perfusion:
    Select one or more:
    a. structurally and functionally intact vasculature
    b. appropriate cardiac function
    c. normal volume and composition of perfusion fluid (Hb, plasma proteins, corpuscular elements etc.)
    d. normal lung function

Answer 23

a/b/c/d/

Question 24

24. Factors enhancing the development of ARDS in shock :
Select one or more:
a. tachypnea
b. over activation of the immune system
c. bronchoconstriction
d. alveolar fluid accumulation

Answer 24

b/d

Question 25

``` 25. Clinical signs indicating circulatory shock: Select one or more: a. pallor b. redness, fever c. respiratory rate < 7/min d. respiratory rate > 29/min ```

Answer 25

a/b/c/d

Question 26

26. Mechanisms leading to the irreversible phase of hemorrhagic shock: Select one or more: a. increased sympathetic tone b. accumulation acidic metabolites c. contraction of precapillary sphincters d. microembolization

Answer 26

d

Question 27

27. Causal factors of hyperdynamic stage in distributive shock: Select one or more: a. increased NO production due to iNOS activity b. accumulation of octopamine c. accumulation of lactic acid d. hypothermia

Answer 27

a/b/c

Question 28

28. Indicative finding for shock if the shock index is: Select one: a. ≤ 0.5 32 b. ≥ 1 c. ≤ 1 d. 0.5 e. BLANK - NO NUMBER 29. Cardiogenic shock can be caused by: Select one or more: a. rupture

Answer 28

b

Question 29

``` 29. Cardiogenic shock can be caused by: Select one or more: a. rupture of the septum b. embolism c. ventricular fibrillation d. pneumothorax ```

Answer 29

a/b/c/d

Question 30

30. Pathological changes of adipose tissue in shock: Select one or more: a. Increased lipolysis b. Increased glucose uptake in adipose tissue c. Development of hypoxia due to centralization of circulation d. Increased formation of ketone bodies in adipose tissue

Answer 30

c

Question 31

31. (Characteristic) metabolic alterations in shock: Select one or more: a. increased glucose uptake by muscle cells b. decreased glucose oxidation in muscle cells c. increased serum glucose level d. increased proteolysis in the muscle e. increased ketogenesis f. decreased glucose oxidation in muscle cells g. decreased serum glucocorticoid level h. decreased lipolysis in adipose tissue

Answer 31

a/b/c/d/e/f/

Question 32

32. Compensatory mechanism in shock: a. Chemoreceptor reflexes b. Baroreceptor reflexes c. Reabsorption of tissue fluid d. Cerebral ischemia

Answer 32

a/b/d