?

q viva
* Cardiac tamnonade: Compression of the heart due to collection of fluici or blood in the pericardiai
cavity.

Q. Classify hemorrhagic shock.

Answer
Classification of hemorrhasic shock:

[Ref- Bailey & Love's l26rh /20)

Q. Classify shock according to severity" [RU-14J,12J]
Answer
Classifv shock accordins to severitv:

o In compensated shock there is aclequate compensation to maintain the central blood vokmre and
preserve flow to the kidneys, lungs and brain.
. Apart from a tachycardia and i:eiol peripheries there may be no other clinical signs ,.'if
hypovolaemia.
c Loss of around i57,: of the circulating blood volume is witliin normal compensatory
mechanisms.

c Ftuther loss of circulating voiume overloads the body's compensatoly mechanisms anil there is
progressive renal, respiratcry and cardiovascular decompensation. In general.
" Blood pressure only falls after 3O40Vc of the circulating volume has been lost.

o InitialiY there is tachycardia, tachypnoea and a mild rcduction in urine outpur anrJ the pafient
may exhibit mild aruiiety.
e Blood pressure is maintaitred althougli ilere is a decrease in prrlse pressure.

e As shock progresses. renal compensatiriv nechanisms fail, renai perfusion t'alls and urine
output dips helovr 0.5 ml per kg per hour.
o There is further tachycardia and n*w the btrood pressure starts to fall.
o Patients become drowsy and mildly cc,i:nrsed.

o In severe shock there is profound tachycardia and hypotension.

. Urine output falls to zero and patlents are unconscious with latroured respiration.

[Ref- Baitey & Love's /26th I fij

Q.lVrite down the pathophysiology of shock. IRU-12J1
Answer
Pathonhvsioloey of shocki

anaerohic mstaholism * accumulation of lactic acid in the biood ** systenic metabolic acidosis --->
glucose rvithin *ells is exhausted, anaerobic respiration eeases ---+ failure of the sodium/potassium
pxmps in the cell n:.embrane and intracellular organelles --+ intracellular lysosomes release
autodigestive enzy,1!ir' :rnd cell i"ysis ensues.