Recording-2025-03-25T22:00:09.698Z

Exam Details• Next exam is in two weeks from today (not next Tuesday).• Review of the test material will take place on the next Tuesday.• Homework through Pearson counts as a fourth test grade and not completing it will result in lost points.

Shock Overview• Shock defined as circulatory failure - inadequate circulation of blood leading to insufficient oxygen delivery to tissues.• Consequence: Tissue hypoxia leads to cell death, organ failure, and potentially, death.• Types of Shock:

• Cardiogenic Shock: Caused by heart failure, e.g., heart attack, cardiomyopathy.

• Hypovolemic Shock: Caused by significant fluid loss (e.g., bleeding, severe dehydration).

• Septic Shock: Resulting from systemic infection leading to organ dysfunction.

• Obstructive Shock: Due to an obstruction to blood flow (e.g., pulmonary embolism, tension pneumothorax).

• Distributive Shock: Includes anaphylactic (severe allergic reaction) and neurogenic (resulting from loss of sympathetic tone).

• Anaphylactic Shock: Life-threatening reaction leading to bronchial constriction.

Mechanism of Shock• Shock represented as an imbalance between oxygen supply and demand.• When cells become hypoxic, they shift to anaerobic metabolism, resulting in lactic acid production (similar to muscle soreness during exercise).• Symptoms of shock include:

• Cold and clammy skin (due to reduced blood flow).

• Decreased urine output (body retains fluid).

• Altered mental status (due to inadequate blood flow to the brain).

• Tachycardia as a compensatory mechanism to increase cardiac output.

Signs and Symptoms• Patients in shock experience clinical signs due to hypoperfusion which include:

• Weak pulse, increased heart rate, and potential confusion or disorientation.

• From hypovolemia, cool, clammy skin, and risk of multi-organ dysfunction syndrome (MODS) as a late sign.

Types of Shock Explained:

1. Hypovolemic Shock:

   • Caused by excessive fluid loss (e.g., bleeding, severe vomiting).

   • Clinical indicators: Systolic blood pressure below 90; compensatory mechanisms like heart rate and renal activation.

2. Cardiogenic Shock:

   • Heart's inability to maintain adequate blood flow due to damage or failure.

   • Symptoms: Jugular distension, peripheral edema, crackles in lungs, weak and rapid pulse.

3. Septic Shock:

   • Systemic response to infection resulting in inadequate blood supply to organs.

   • Treatment includes fluids, vasopressors, and broad-spectrum antibiotics.

4. Anaphylactic Shock:

   • Severe allergic reactions leading to respiratory failure.

   • Treatment: admin of epinephrine.

Stages of Shock

1. Stage 1: Early, reversible shock; increased heart rate and activated renal function.

2. Stage 2: Intermediate; patient may show confusion as cells become hypoxic.

3. Stage 3: Severe shock; organ failure begins, leading to MODS and high risk of mortality.

Compensation Mechanisms• Heart increases output, kidneys activate to retain fluid, and systemic vascular resistance increases to help maintain blood flow. • Essential for survival is identifying the cause of shock and treatment within the early stages.

Diabetes Overview• Types of diabetes include: Type 1 (autoimmune, requires insulin) and Type 2 (linked to lifestyle, may be managed with diet).• Common symptoms: Increased thirst, frequent urination, weight loss, fatigue.• Long-term complications: Retinopathy, nephropathy, neuropathy, and cardiovascular damage. • Hemoglobin A1C gives an average blood sugar level; normal target is below 7%.• Diabetic Ketoacidosis (DKA) occurs primarily in Type 1 diabetes, resulting in severe high blood sugar coupled with acidosis and dehydration.

Exam Preparation Tips• Revise key concepts of shock types, mechanisms, and symptoms.• Ensure understanding of diabetes type differences and implications.• Familiarize with roles of hormones (insulin, glucagon) in metabolic homeostasis.• Prepare for questions relating to MODS and the body's compensatory systems.