Distributive Shock

Q) 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

MCQs on Shock and Body Response 

Ans a 

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

All other parameters are high

Distributive Shock Symptoms

Vasodilation

Warm peripheries

Hypotension

Causes of Distributive Shock are

  1. Anaphylaxis
  2. High spinal cord injury
  3. Septic shock
  4. Toxic Shock Syndrome
  5. The distributive shock from adrenal insufficiency occurs due to decreased alpha-1 receptor expression on arterioles secondary to cortisol deficiency, which results in vasodilation. This is seen in patients on chronic steroids that are stopped suddenly.

 

Spontaneous Pneumothorax

Q) 15 year old boy, with Spontaneous pneumothorax. He is  dyspneic with increased RR

Next best step #AIIMS GI 2022

a) Vats and pleurodesis

b) Needle aspiration

c) Tube thoracostomy

d) Any of the above

Ans c

Primary spontaneous pneumothorax occurs in young patients without significant lung disease, whereas secondary spontaneous pneumothorax occurs in patients with COPD.

The most common cause of primary spontaneous pneumothorax is rupture of small apical blebs. Tube thoracostomy with water seal drainage is the usual first-line treatment of a moderate-to-large pneumothorax in a patient with a first-time occurrence

Claudication pain

Q) 70 year old male has pain in right buttock on standing and gets relieved on sitting. What will be the next relevant  test to be ordered in him?

a) Doppler B/l lower limbs

b) MRI spine

c) Echo cardiography

d) Ankle Brachial Index