Post Mgmt of Shock 9-18-19
Quiz by Cassiopia Lippold
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47 questions
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- Q1Why is the initial blood pressure goal >65 mm Hg?A large study showed that patients had significant renal and myocardial injury when than 65 mm HgBecause it is a nice round numberA large study showed that it is more harmful the kidney and cardiac muscle when higher than 70 mm HgDogs overall did better in a study30s
- Q2What is the main goal in treating septic shock?To perfuse the brain, and cardiac muscleTo allow / facilitate with antibiotic circulationTo get the MAP greater than 65 mm Hgto have a balance between perfusing organs and cellular death30s
- Q3Why is lactate produced during shock?Kreb cycle malfunction due to ischemiaPurely due to anerobic metabolism of pyruvate to lactate from cell hypoxiaMitochondrial increased demand from glycogen to glucose and glycolysis from beta 2 stimulationCombination of anerobic metabolism and epinephrine cause glycolysis30s
- Q4What is the equation for cardiac output?(Preload – after load) X contractilityHeart rate x Stroke VolumeLOVT area X LVOT velocityStroke volume – peripheral vascular resistance30s
- Q5What is the calculation of oxygen delivery?[(1.5 x hemoglobin x SaO2) x heart rate x (PVR-SVR)] + (0.03 X PaO2)[(1.32 x hemoglobin x SaO2) x cardiac output] + (0.003 X PaO2)Heart rate x stroke volume x (1/ hematocrit)cardiac output x (1/ hematocrit) X (SVR)] - (0.003 X PaO2)30s
- Q6What are signs of poor perfusion?Mottled extremities increase in heart rate, increase in lactic acid, decrease in urine output, increased capillary refill timeMental status change, increase in lactic acid, increase in urine output, decreased capillary refill time, hemoconcentrationDecrease in urine output, decreased capillary refill time, mottled extremitiesMental status change, increase in heart rate, increase in lactic acid, decrease in urine output, increased capillary refill time30s
- Q7Which medications are a pure vasopressors?Norepinephrine, and epinephrineEpinephrine, phenylephrinePhenylephrine, vasopressinNorepinephrine, vasopressin, epinephrine30s
- Q8What does inotropic mean?Increase contractilityIncrease heart rateIncrease diastolic filling timeIncrease conduction velocity30s
- Q9What does chronotropic mean?Increase contractilityIncrease diastolic filling timeIncrease conduction velocityIncrease heart rate30s
- Q10What does inopressor mean?induces venous vasoconstriction and arterial vasodilationincreases cardiac contractility and induces vasoconstrictionincreases heart rate and causes arterial vasoconstrictionincreases cardiac contractility and induces vasodilation30s
- Q11What does inodilator mean?increases heart rate and causes arterial vasoconstrictionincreases cardiac contractility and induces vasoconstrictionincreases cardiac contractility and induces vasodilationinduces venous vasoconstriction and arterial vasodilation30s
- Q12Which medications are inodilators?Dobutamine, milrinone, dopamineEpinephrine, dopamine, milrinoneMilrinone, dobutamine, epinephrineisoproterenol, dobutamine, milrinone30s
- Q13What receptor causes free water reabsorption in the kidney?V1 + V2V1V230s
- Q14Vasopressin works on which receptors?V1 and V2V2 at low doses and then V1>V2 at high dosesV1 at low doses and then V2>V1 at high dosesV1 only30s
- Q15Which receptor causes smooth muscle vasoconstriction?Beta 1Alpha 1Alpha 2Beta 230s