Question 1

The main cause of cardiogenic shock is

Accepted Answer

A)  an inability of the heart to pump blood forward. 
B)  hypovolemia, resulting in decreased stroke volume. 
C)  disruption of the conduction system when re-entry phenomenon occurs. 
D)  an inability of the heart to respond to inotropic agents. 
A)  an inability of the heart to pump blood forward. 
B)  hypovolemia, resulting in decreased stroke volume. 
C)  disruption of the conduction system when re-entry phenomenon occurs. 
D)  an inability of the heart to respond to inotropic agents.

Question 2

A patient has been on the medical floor for 1 week after a vaginal hysterectomy.A urinary catheter was inserted.Complete blood cell count results have revealed escalating white blood cell counts.The patient is transferred to the critical care unit when her condition deteriorates.Septic shock is diagnosed.Which of the following is the pathophysiologic mechanism that results in septic shock?

Accepted Answer

A)  Bacterial toxins lead to vasodilation. 
B)  Increased white blood cells are released to fight invading bacteria. 
C)  Microorganisms invade organs such as the kidneys and heart. 
D)  An increase of white blood cells leads to decreased red blood cell production and anemia. 
A)  Bacterial toxins lead to vasodilation. 
B)  Increased white blood cells are released to fight invading bacteria. 
C)  Microorganisms invade organs such as the kidneys and heart. 
D)  An increase of white blood cells leads to decreased red blood cell production and anemia.

Question 3

Laboratory values for DIC show abnormalities in

Accepted Answer

A)  liver function tests. 
B)  tests for renal function. 
C)  platelet counts. 
D)  blood glucose levels. 
A)  liver function tests. 
B)  tests for renal function. 
C)  platelet counts. 
D)  blood glucose levels.

Question 4

The difference between primary and secondary multiple organ dysfunction syndrome (MODS)is that primary MODS is the result of

Accepted Answer

A)  widespread systemic inflammation that results in dysfunction of organs not involved in the initial insult. 
B)  direct organ injury. 
C)  disorganization of the immune system response. 
D)  widespread disruption of the coagulation system. 
A)  widespread systemic inflammation that results in dysfunction of organs not involved in the initial insult. 
B)  direct organ injury. 
C)  disorganization of the immune system response. 
D)  widespread disruption of the coagulation system.

Question 5

Which of the following hemodynamic parameters supports the diagnosis of cardiogenic shock?

Accepted Answer

A)  Increased right atrial pressure 
B)  Decreased pulmonary artery wedge pressure 
C)  Increased cardiac output 
D)  Decreased cardiac index 
A)  Increased right atrial pressure 
B)  Decreased pulmonary artery wedge pressure 
C)  Increased cardiac output 
D)  Decreased cardiac index

Question 6

A vasoconstrictor used to treat shock is

Accepted Answer

A)  adrenaline. 
B)  Nipride. 
C)  Dobutrex. 
D)  adenosine. 
A)  adrenaline. 
B)  Nipride. 
C)  Dobutrex. 
D)  adenosine.

Question 7

Immunoglobulin E (IgE)-mediated anaphylactic shock occurs as a result of

Accepted Answer

A)  direct activation of mast cells. 
B)  laryngeal edema. 
C)  an antigen entering on a repeat exposure, triggering a secondary immune response. 
D)  the systemic inflammatory response. 
A)  direct activation of mast cells. 
B)  laryngeal edema. 
C)  an antigen entering on a repeat exposure, triggering a secondary immune response. 
D)  the systemic inflammatory response.

Question 8

Clinical manifestations of ischemic hepatitis show up 1 to 2 days after the insult.Which symptom below is indicative of hepatic insufficiency?

Accepted Answer

A)  Elevated serum creatinine 
B)  Decreased bilirubin 
C)  Jaundice 
D)  Decreased serum transaminase 
A)  Elevated serum creatinine 
B)  Decreased bilirubin 
C)  Jaundice 
D)  Decreased serum transaminase

Question 9

A patient has been on the medical floor for 1 week after a vaginal hysterectomy.A urinary catheter was inserted.Complete blood cell count results have revealed escalating white blood cell counts.The patient is transferred to the critical care unit when her condition deteriorates.Septic shock is diagnosed.A pulmonary artery catheter is placed.Which of the following hemodynamic values would you expect to find?

Accepted Answer

A)  Cardiac output of 8 L/min 
B)  Right atrial pressure of 17 mm Hg 
C)  Pulmonary artery wedge pressure of 23 mm Hg 
D)  Systemic vascular resistance of 1100 
A)  Cardiac output of 8 L/min 
B)  Right atrial pressure of 17 mm Hg 
C)  Pulmonary artery wedge pressure of 23 mm Hg 
D)  Systemic vascular resistance of 1100

Question 10

One theory suggests that organ dysfunction in MODS occurs in a sequential or progressive pattern.Place the following organs in the order in which they are affected:
1)Bone marrow
2)Cardiac
3)Gut
4)Kidneys
5)Liver
6)Lungs

Accepted Answer

A)  6, 5, 2, 1, 3, 4 
B)  5, 4, 6, 1, 2, 3 
C)  6, 5, 3, 4, 2, 1 
D)  6, 3, 4, 5, 2, 1 
A)  6, 5, 2, 1, 3, 4 
B)  5, 4, 6, 1, 2, 3 
C)  6, 5, 3, 4, 2, 1 
D)  6, 3, 4, 5, 2, 1

Exam 35: Shock,sepsis,and Multiple Organ Dysfunction Syndrome

The main cause of cardiogenic shock is

Laboratory values for DIC show abnormalities in

The difference between primary and secondary multiple organ dysfunction syndrome (MODS)is that primary MODS is the result of

Which of the following hemodynamic parameters supports the diagnosis of cardiogenic shock?

A vasoconstrictor used to treat shock is

Immunoglobulin E (IgE)-mediated anaphylactic shock occurs as a result of

Clinical manifestations of ischemic hepatitis show up 1 to 2 days after the insult.Which symptom below is indicative of hepatic insufficiency?

One theory suggests that organ dysfunction in MODS occurs in a sequential or progressive pattern.Place the following organs in the order in which they are affected: 1)Bone marrow 2)Cardiac 3)Gut 4)Kidneys 5)Liver 6)Lungs

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