General Surgery Body response to injury

Shock &  Body Response to Injury ( 12) 

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Q1. Counter regulatory hormones in response to metabolic response to injury are all except
A. Glucocorticoids
B. Catecholamines
C. Thyroid hormones
D. Glucagon

Ans 1.  C Thyroid hormones

Stress or Injury produces the following hormones CRF, ACTH, cortisol which further produces adrenaline and glucagon

Thyroid hormones have no relation to stress

Ref BAiley page 3

Q2. Direct effects of GH in metabolic response to injury are all except:-
A. Lipolytic
B. Insulin agonist
C. Insulin antagonist
D. Proinflammatory

Ans 2.b

 Insulin agonist GH has direct lipolytic, insulin-antagonising and proinflammatory properties

 Stress also causes the following ;

Alterations in insulin release and sensitivity (Hyperglycemic state)

Hypersecretion of prolactin and growth hormone (GH)

Q3.) What is not seen in Distributive Shock?

a) High central venous pressure

b) High Cardiac output

c) High Base deficit

d) High Mixed Venous Saturation

Ans 3) a 

In Distributive shock Systemic vascular resistance and venous pressure are low ( because of vasodilation)

All other parameters are high

Causes of Distributive Shock are

  1. Anaphylaxis
  2. High spinal cord injury
  3. Septic shock
  4. Toxic Shock Syndrome

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Important points from this chapter ( Only High yield for NEET SS ) 

  1. Ebb phase lasts for 24-48 hours
  2. Chemoreceptors in the aorta and carotid bodies are sensitive to changes in O2 tension, H+ ion concentration, and carbon dioxide (CO2) levels
  3. After Shock catecholamine levels peak for 24-48 hrs


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