Question

Define shock and explain its categories of causes?

Answer 1

The 'true shock' is defined as circulatory imbalance between supply of oxygen and requirement of an oxygen at the cellular level and is also called as circulatory shock.'Shock' is a life threatening clinical syndrome that is characterised by adequate reduction of effective circulatory blood volume and and an inadequate perfusion of cells and tissues lead to damage of many organs and sometime lead to death.

Classification/categories

Shock is classified in to three major types and other variants:. 1. Hypovolaemic shock- The shock in which it results from inadequate blood loss or other fluid loss by the various etiologic factors that may be either from the loss of red cell mass and plasma due to hemorrhage,burns,acute pancreatitis,overuse of diuretics.This type of shock can cause stoppage to many other organs and this will come under the emergency condition.

2. Cardiogenic shock-. Is a serious condition in which there is acute circulatory failure with immediate reduction in cardiac output from acute disease of heart without actual reduction of blood volume results in cardiogenic shock.This a medical emergency and it should be treated immediately.And the heart cannot pump adequate amount of blood to meet the body needs.The causes for cardiogenic shock are rupture of heart,ventricles due to increased pressure,cardiac arrhythmias,myocardial infarction,obstruction to the outflow such as pulmonary embolism means sudden blockage of blood vessel in the lungs,dissecting aortic aneurysm.Cardiogenic shock is most commonly result in heart attack.

3. Septic shock- is defined as Severe infections that occurs by bacteria that induce the septic shock and is a life threatening condition organ dysfunction due to dysregulated host response to infection and lowers the blood pressure.It may be result by Gram- negative septicemia which is more common such as infection with E-coli, Proteus,Klebsiella,pseudomonas and is a endotoxic shock or less common from Gram -positive septicemia such as infection with streptococci,pneumococci and is a exotoxic shock.

4. Other types is traumatic and neurogenic shock:. . Neurogenic shock- results from causes of interruption of sympathetic vasomotor supply. Causes are accidental high spinal anaesthesia,severe head injury,severe spinal cord injury. . Traumatic shock- occurs fro trauma that is initially due to reduction of blood volume but even after hemorrhage is controlled there is continues loss of plasma volume in to interstitial space of injured tissue which should be suffered by the patient. Causes are severe injuries,obstetrical tumour,surgery with marked blood loss. . Hypoadrenal shock - occurs in which the patient fails to respond normally to stress of trauma,surgery or any disease which can occurs from unknown adrenal insufficiency. Causes are administration of high doses of glucocorticoids,and( tuberculosis idiopathic adrenal atrophy,metastatic disease) which comes under the secondary adrenal insufficiency.

Complication of shock are : Acute renal failure. Disseminated intravascular coagulation. Acute respiratory distress syndrome. Multiple organ dysfunction syndrome.