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| << < | * Step 1 * 2006 Archives * | > >> |
| * What kind of Shock? |
| | #134421 |
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A 82–year-old diabetic is involved in an automobile accident, with severe thoracic and abdominal traumatic injuries. He is rushed to the hospital and placed in the intensive care unit. After a few hours, there is the rapid onset of myocardial dysfunction, hypotension, disseminated intravascular coagulation, and coma. This sequence of events most closely mimics what type of shock?
A. Anaphylactic
B. Cardiogenic
C. Hypovolemic
D. Neurogenic
E. Septic
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| * Re:What kind of Shock? |
| #538578 |
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no, the correct answer is : E
The correct answer is E. Septic shock is a complex, multisystem organ failure that can be produced either by LPS (which is present in the cell wall of all gram-negative bacteria) or certain toxins released by gram-positive bacteria and fungi. LPS binds to a serum protein and stimulates CD14 receptors on endothelial cells and circulating inflammatory cells, eliciting a broad range of end-organ responses.
Anaphylactic shock (choice A) is brought about by an exaggerated Type I hypersensitivity reaction mediated by IgE antibodies bound to mast cells and basophils. The resulting degranulation produces massive histamine and adenosine release, which produces constriction of the bronchi and pulmonary circulation.
Cardiogenic shock (choice B) reflects the inability of the heart to maintain arterial pressure sufficiently to perfuse the systemic vasculature. Cardiogenic shock is intrinsic to the heart and usually a consequence of ischemia, arrhythmia, or obstruction.
Hypovolemic shock (choice C) occurs when blood volume decreases to a point at which it is inadequate to maintain arterial pressure in the vital organs. Hypovolemic shock is due to hemorrhage, fluid loss from burns, or severe diarrhea and vomiting.
Neurogenic shock (choice D) is an unusual form of shock that occurs in catastrophic nervous system injuries that cause diffuse vasodilation and hypotension.
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