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Shock and Sepsis

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VMRCVM Gen Vet Med, class of 2016. Lecture 2.
voakes
Quiz by voakes, updated more than 1 year ago
voakes
Created by voakes about 10 years ago
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Resource summary

Question 1

Question
What is shock?
Answer
  • Unconsciousness following a traumatic event.
  • A state of hypervolemia, usually associated with tachycardia.
  • Electrocution followed by cardiac arrhythmia and patient anorexia.
  • Poor tissue perfusion.

Question 2

Question
Which of the following are classifications of shock? Select all that apply.
Answer
  • Hypovolemic shock
  • Hypervolemic shock
  • Obstructive shock
  • Distributive shock
  • Cardiogenic shock
  • Hepatogenic shock

Question 3

Question
When the body is presented with low blood volume, it shunts blood away from splanchnic and skin circulation.
Answer
  • True
  • False

Question 4

Question
A state of hypovolemia is always classified as being in "shock."
Answer
  • True
  • False

Question 5

Question
Many of the clinical signs of shock are due to compensatory mechanisms of the body to hypovolemia.
Answer
  • True
  • False

Question 6

Question
What is the difference between compensated and progressive shock?
Answer
  • The difference is strictly temporal; both compensated and progressive shock are characterized by normal mentation and normal to slightly elevated vitals, with good prognosis for both.
  • The difference is strictly temporal; both compensated and progressive shock are characterized by altered mentation and significantly altered vitals, with poor prognosis for both.
  • Compensated shock is characterized by normal mentation and normal to slightly elevated vitals, whereas progressive shock is characterized by altered mentation and vitals.
  • Compensated shock is characterized by altered mentation and altered vitals, whereas progressive shock is characterized by normal mentation and normal to slightly elevated vitals.

Question 7

Question
The goal of treatment for shock is to restore adequate oxygen delivery to the tissue. We do this by increasing blood volume. Accordingly, our very first go-to fluid therapy is:
Answer
  • Colloid fluids in boluses of 90 mg/kg (dog) or 60 mg/kg (cat)
  • Crystalloid fluids in boluses of 90 mg/kg (dog) or 60 mg/kg (cat)
  • Crystalloid fluids in boluses of less than 90 mg/kg (dog) or 60 mg/kg (cat)
  • Colloid fluids in boluses of less than 90 mg/kg (dog) or 60 mg/kg (cat)

Question 8

Question
Colloids are indicated for treatment of shock in which of the following cases? Select all that apply.
Answer
  • The patient has significantly decreased electrolyte values.
  • The patient is hypoproteinemic.
  • The patient is diabetic.
  • The patient has not responded to crystalloid administration.

Question 9

Question
Oxygen therapy is indicated in patients suffering from which of the following types of shock? Select all that apply.
Answer
  • Cardiogenic
  • Hypovolemic
  • Obstructive
  • Distributive

Question 10

Question
How does hypothermia complicate fluid therapy?
Answer
  • Vasoconstriction of peripheral blood vessels impairs vascular response.
  • Cold tissues encourage offloading of fluids to the interstitial space.
  • Shivering can displace catheters.
  • Microscopic ice crystals can form in the veins, impeding venous blood flow.

Question 11

Question
Which of the following are acceptable treatment modalities for managing a patient in shock? Select all that apply.
Answer
  • Fluid therapy
  • Vasopressors & positive inotropes
  • NSAIDs
  • Oxygen
  • Warming
  • Blood transfusions
  • Amputation
  • Sodium bicarbonate

Question 12

Question
What is the difference between systemic inflammatory response syndrome (SIRS) and sepsis?
Answer
  • Nothing, the two terms are synonymous and may be used interchangeably.
  • SIRS refers specifically to auto-immune responses, whereas sepsis refers to infectious responses.
  • SIRS refers to inflammation throughout the body, whereas sepsis refers specifically to inflammation caused by bacteria in the blood.
  • SIRS includes infectious and non-infectious inflammatory stimuli, whereas sepsis specifically refers to infectious inflammatory stimuli.

Question 13

Question
At what point is patient considered to be in septic shock?
Answer
  • When a blood smear identifies bacteria in the blood, and the patient is hypoproteinemic.
  • When a patient is hypotensive following an inflammatory response to an infectious agent, and they've become unresponsive to fluid therapy.
  • When a patient is hypotensive following an inflammatory response to an infectious agent but responding to fluids.

Question 14

Question
Which of the following is true regarding the difference in clinical signs between early sepsis and late sepsis?
Answer
  • Early sepsis is not associated with altered mentation, whereas late sepsis is characterized by depression.
  • Early sepsis generally involves bradycardia, whereas late sepsis generally involves tachycardia.
  • Early sepsis is characterized by pale mucous membranes and weak pulses, whereas in late sepsis a patient will have red mucous membranes and a bounding pulse.
  • None of these answer choices are correct.

Question 15

Question
Which of the following are risk factors for sepsis? Select all that apply.
Answer
  • Immunosuppressed animal
  • Localized infection
  • Presence of a catheter
  • Surgery

Question 16

Question
Hypoglycemia is expected in patients suffering from sepsis.
Answer
  • True
  • False

Question 17

Question
What are two key things to keep in mind when treating sepsis? Select all that apply.
Answer
  • Be absolutely sure that you've identified the correct infectious agent - it may take a little longer to get your culture back, but the time spent is worth it.
  • Start your patient on treatment as early as possible.
  • Be aggressive in your treatment to prevent the infection from worsening.
  • The source of the infection is immaterial, since the organism is now in the blood.
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