Circulatory Shock and Its Treatment

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Questions

Question 1

What is the defining characteristic of irreversible shock?

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Question 2

According to the graph in Figure 24-6, what happens to cardiac output immediately after a transfusion is given during the irreversible stage of shock?

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Question 3

What is described as one of the most devastating and significant end results for the development of the final state of irreversibility in shock?

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Question 4

What is the approximate rate at which new adenosine can be synthesized by cells after the high-energy phosphate stores have been depleted during severe shock?

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Question 5

What is the primary cause of hypovolemic shock resulting from severe burns?

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Question 6

Besides hemorrhage, how can extensive bodily contusion during trauma lead to hypovolemic shock?

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Question 7

What is a key characteristic of hypovolemic shock caused by plasma loss that distinguishes it from shock caused by hemorrhage?

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Question 8

What is the primary mechanism that causes neurogenic shock?

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Question 9

Which of the following conditions is listed as a potential cause of neurogenic shock due to vasomotor paralysis?

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Question 10

While brief brain ischemia causes extreme vasomotor stimulation, what is the effect of prolonged brain ischemia lasting more than 5 to 10 minutes?

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Question 11

In anaphylactic shock, which substance is released by basophils and mast cells in response to an antigen-antibody reaction?

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Question 12

Which of the following is NOT described as a primary effect of histamine release during anaphylactic shock?

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Question 13

Excluding cardiogenic shock, what is the most frequent cause of shock-related death in the hospital setting?

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Question 14

Which of the following features is often observed in patients with septic shock, particularly in about half of the cases?

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Question 15

What is disseminated intravascular coagulation, a condition that can develop in septic shock?

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Question 16

What is identified as the best possible therapy for a person in shock caused by hemorrhage?

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Question 17

Why is plasma transfusion considered an adequate substitute for whole blood in the emergency treatment of hemorrhagic shock?

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Question 18

What is the principal requirement for a substance, such as dextran, to be an effective plasma substitute?

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Question 19

In which type of shock are sympathomimetic drugs like epinephrine considered particularly lifesaving?

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Question 20

Why have sympathomimetic drugs proven to be not very valuable in the treatment of hemorrhagic shock?

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Question 21

What is the recommended initial 'head-down' position for treating a patient in hemorrhagic or neurogenic shock?

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Question 22

What is the primary limitation of oxygen therapy in treating most types of shock, making it less beneficial than might be expected?

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Question 23

What is one of the reasons glucocorticoids are sometimes given to patients in severe shock?

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Question 24

What is the maximum duration of total circulatory arrest that more than half of patients can withstand before incurring some degree of permanent brain damage?

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Question 25

What is the typical consequence for a person's mental capacity following a circulatory arrest that lasts for 10 to 15 minutes?

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Question 26

In addition to acute cerebral hypoxia, what other factor has been shown by experiments to prevent much of the early brain deterioration during circulatory arrest?

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Question 27

In animal experiments, what was the effect of administering heparin or streptokinase before cardiac arrest?

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Question 28

What happens to the actions of the hormone insulin during the last stages of shock?

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Question 29

In cases of shock, where in a capillary bed does more nutritive deficiency and subsequent tissue necrosis tend to occur?

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Question 30

What is the term for the condition where deterioration of the lungs following shock leads to respiratory distress and death several days later?

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Question 31

What is the primary reason that metabolic acidosis develops in shock?

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Question 32

During shock, when cells switch to the anaerobic process of glycolysis for energy, what substance accumulates in the blood?

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Question 33

How does the poor blood flow through tissues in shock contribute to the formation of intracellular carbonic acid?

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Question 34

The deteriorative factors in shock, where each increase in the degree of shock causes a further increase, are an example of what type of mechanism?

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Question 35

What is the ultimate fate of much of the adenosine that diffuses out of cells during severe shock?

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Question 36

A patient with a severe intestinal obstruction develops shock. This is a form of hypovolemic shock caused by what mechanism?

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Question 37

What is the main conclusion from cross-transfusion experiments with normal animals regarding the cause of shock after trauma?

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Question 38

In neurogenic shock, what is the physiological term for the diminished venous return caused by widespread vascular dilation?

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Question 39

Which statement accurately describes the state of cardiac output in patients with septic shock?

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Question 40

In the context of septic shock, what causes the phenomenon known as 'sludging of the blood'?

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Question 41

What is the primary reason it is considered reasonable to use plasma instead of whole blood for the emergency treatment of most types of hypovolemic shock?

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Question 42

Which type of shock results primarily from an allergic antigen-antibody reaction?

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Question 43

What is the effect of deep general anesthesia on the vasomotor center of the brain?

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Question 44

How can spinal anesthesia become a potent cause of neurogenic shock?

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Question 45

Which of the following conditions is a cause of hypovolemic shock due to dehydration and loss of aldosterone secretion?

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Question 46

During the progression of shock, what happens to the mitochondrial activity in liver cells and many other tissues?

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Question 47

What is the consequence of lysosomes breaking open in cells during widespread tissue shock?

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Question 48

According to the text, which three organs are listed as being especially affected by the further deterioration that occurs during shock?

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Question 49

As depicted in the graph of Figure 24-6 showing the progression of shock, what happens to cardiac output after hemorrhage?

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Question 50

What is the key difference between circulatory shock and circulatory arrest?

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