Which of the following are types of shock and their respective causes? (Select All that Apply.)
Neurogenic shock - caused by a disruption in the autonomic nervous system.
Hypovolemic shock - caused by severe blood loss or fluid loss.
Metabolic shock - caused by severe metabolic acidosis.
Anaphylactic shock - caused by an allergic reaction.
Septic shock - caused by a severe infection.
Cardiogenic shock - caused by a failure of the heart to pump effectively.
Correct Answer : A,B,D,E,F
Choice A Reason:
Neurogenic shock occurs due to a disruption in the autonomic nervous system, often resulting from spinal cord injuries. This disruption leads to a loss of sympathetic tone, causing widespread vasodilation and a subsequent drop in blood pressure. The hallmark of neurogenic shock is hypotension with bradycardia, which differentiates it from other types of shock that typically present with tachycardia. The loss of vascular tone results in pooling of blood in the extremities, reducing venous return to the heart and decreasing cardiac output.
Choice B Reason:
Hypovolemic shock is caused by a significant loss of blood or fluids, leading to inadequate circulating volume. This can result from trauma, surgery, gastrointestinal bleeding, or severe dehydration. The primary mechanism is a reduction in preload, which decreases stroke volume and cardiac output. Clinical signs include tachycardia, hypotension, and cool, clammy skin. Rapid fluid resuscitation is critical to restore circulating volume and improve tissue perfusion.
Choice C Reason:
Metabolic shock is not a recognized type of shock in medical literature. The term might be confused with metabolic acidosis, which can occur secondary to shock but is not a primary cause. Metabolic acidosis results from the accumulation of lactic acid due to anaerobic metabolism when tissues are inadequately perfused. Therefore, metabolic shock is not considered a valid type of shock.
Choice D Reason:
Anaphylactic shock is a severe, life-threatening allergic reaction that leads to widespread vasodilation, increased capillary permeability, and bronchoconstriction. Common triggers include foods, insect stings, medications, and latex. Symptoms include hypotension, swelling, difficulty breathing, and hives. Immediate administration of epinephrine is crucial to counteract the severe allergic response and stabilize the patient.
Choice E Reason:
Septic shock results from a severe infection that leads to systemic inflammation and widespread vasodilation. The infection triggers an overwhelming immune response, causing damage to blood vessels and organs. Clinical features include fever, hypotension, tachycardia, and altered mental status. Early recognition and aggressive treatment with antibiotics and fluid resuscitation are essential to improve outcomes.
Choice F Reason:
Cardiogenic shock occurs when the heart fails to pump effectively, leading to inadequate tissue perfusion. Common causes include myocardial infarction, severe heart failure, and arrhythmias. Symptoms include hypotension, tachycardia, and signs of poor perfusion such as cool extremities and altered mental status. Treatment focuses on improving cardiac output through medications, mechanical support, or revascularization procedures.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A: Palpitations
Palpitations, or the sensation of a rapid or irregular heartbeat, can occur in various heart conditions, including left heart failure. However, they are not the most common or specific symptom of left heart failure. Palpitations can be caused by arrhythmias, anxiety, or other cardiac issues. In the context of left heart failure, the heart's inability to pump blood effectively leads to fluid buildup in the lungs, causing shortness of breath, which is a more direct and common manifestation.
Choice B: Peripheral edema
Peripheral edema, or swelling in the legs and ankles, is more commonly associated with right-sided heart failure. In right-sided heart failure, the heart's right ventricle fails to pump blood efficiently, leading to fluid accumulation in the body's extremities. While peripheral edema can occur in left heart failure, it is not as common as shortness of breath. Left heart failure primarily affects the lungs, leading to pulmonary congestion and shortness of breath.
Choice C: Shortness of breath
Shortness of breath, or dyspnea, is the hallmark symptom of left heart failure. When the left side of the heart fails to pump blood effectively, blood backs up into the pulmonary veins, causing fluid to leak into the lungs. This results in pulmonary congestion and difficulty breathing. Patients with left heart failure often experience shortness of breath during physical activity, while lying down (orthopnea), or waking up at night (paroxysmal nocturnal dyspnea). This symptom is a direct consequence of the heart's reduced ability to manage blood flow and is a key indicator of left heart failure.
Choice D: Chest pain
Chest pain can be a symptom of various cardiac conditions, including coronary artery disease, myocardial infarction (heart attack), and angina. While chest pain can occur in heart failure, it is not the most common manifestation of left heart failure. The primary issue in left heart failure is the heart's inability to pump blood effectively, leading to fluid buildup in the lungs and shortness of breath. Chest pain is more typically associated with ischemic heart conditions rather than heart failure itself.
Correct Answer is D
Explanation
Choice A Reason:
Hypotension is not typically a direct manifestation of increased intracranial pressure (ICP). In fact, increased ICP often leads to hypertension as part of Cushing's triad, which includes hypertension, bradycardia, and irregular respiration. Hypotension may indicate other issues such as shock or blood loss but is not a primary indicator of increased ICP.
Choice B Reason:
Tachypnea, or rapid breathing, is not a primary sign of increased ICP. While respiratory changes can occur with increased ICP, they are more likely to present as irregular breathing patterns rather than simply an increased rate. Tachypnea might be seen in conditions like anxiety, pain, or respiratory distress but is not a hallmark of increased ICP.
Choice C Reason:
Bilateral weakness of extremities can occur with increased ICP, especially if there is significant brain swelling or herniation affecting motor pathways. However, it is not the most immediate or specific sign. Other neurological deficits can also cause bilateral weakness, so it is not solely indicative of increased ICP.
Choice D Reason:
Decreased level of consciousness is a critical and primary sign of increased ICP. As pressure within the skull rises, it can compress brain structures and impair function, leading to altered mental status ranging from confusion to coma. Monitoring the level of consciousness is essential in assessing and managing patients with potential increased ICP.
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