fongch
Forum Elite
Topics: 71
Posts: 316
|
A 82-year-old diabetic is involved in an automobile accident with severe thoracic and abdominal traumatic injuries. He is rushed to the hospital and placed in the ICU. After a few hours, there is rapid onset of myocardial dysfunction, hypotension, DIC and coma. The sequence of events most closely mimics which type of shock?
A Anaphylactic
B Cardiogenic
C Hypovolemic
D Neurogenic
E Septic
This is a question from Kaplan Qbank.
Please post explanation when you answer.
|
| drpkaur
Forum Guru
Topics: 195
Posts: 808
|
E??
|
| fox
Forum Guru
Topics: 70
Posts: 727
|
Sepsis withis few hours of injury?!?!?
___________________
Aim High
|
| smal
Forum Guru
Topics: 140
Posts: 727
|
E,
coz pt being diabetic,high chances of easy infection.and pt does devlope DIC .
___________________
remedy for weakness is not brooding over it ,but thinking of strength.
|
| ManuNastai
Transilvanian..
Topics: 55
Posts: 838
|
I also go with E because from my knowledge, you don't have DIC in any of the other types of shock
___________________
"Love is the only inflamation of the heart that drains in the vagina" (translation after Dr Petre Florescu, Professor of Pathology, UMF "Iuliu Hatieganu", Cluj Napoca
|
| ssrpk
Forum Fanatic
Topics: 154
Posts: 2,819
|
agree with ManuNastai! DIC does'nt fit with others!
___________________
life is guud
|
| klimt
Forum Guru
Topics: 27
Posts: 605
|
agree E
it could either be hypovolemic or cardiogenic shock, but DIC occurs only in septic shock, so E..
___________________
Traveler, there are no roads. Roads are made by walking.
|
| fox
Forum Guru
Topics: 70
Posts: 727
|
100% agree that DIC is unique to sepsis.....but I was hesitant as it says Patient developed shock within a few hours of injury...how do u explain that? There should be some latent period for infection right?
___________________
Aim High
|
| fongch
Forum Elite
Topics: 71
Posts: 316
|
Really? I seem to remember DIC will take place in the end decompensated stage of all form of shock.
|
| me007
Forum Guru
Topics: 72
Posts: 803
|
from Goljan Pathology
etiology of DIC -
1. sepsis - most common
2. disseminated malignancy
3. trauma with crush injuries,
rattlesnake envenomation
So, what kind of shock in trauma?
|
| rubensssss
Forum Guru
Topics: 95
Posts: 451
|
I don't thinkl is E
I wil go for B or C
To answer the question I will go for C The easy one
___________________
Ruben sssss
|
| me007
Forum Guru
Topics: 72
Posts: 803
|
hypovolemic, cardiogenic and septic shocks can go with circulatory collapse, which is
associated with tachycardia or bradycardia, reduced cardiac output, hypotension, reduced tissue perfusion and evidence of multiorgan dysfunction such as mental depression, oliguria, and DIC.
http://mindful.freeshell.org/data/01500151.html
there is nothing about hypovolemia in this question, but there is myocardial disfunction.
might be ans cardiogenic?
|
| me007
Forum Guru
Topics: 72
Posts: 803
|
should we presume that he lost blood because of injuries and he is hypovolemic or
that 82-y.o diabetic predisposed to myocardial troubles?
Or there is something else i'm missing?
|
| mediocre
Forum Elite
Topics: 37
Posts: 229
|
i will go with C aswell,dic cud be as stated by me007 dto crush /trauma
___________________
"Do not worry if you have built your castles in the air. They are where they should be. Now put the foundations under them." - Henry David Thoreau
|
| fongch
Forum Elite
Topics: 71
Posts: 316
|
The answer provided is E, though.
|
| inkspot
Forum Guru
Topics: 30
Posts: 586
|
E
remember the patient is diabetic aswell this makes him more prone to infections aswell ! old age means less imunity and then other folks here have summarized it well ! septicemia and DIC have strong link
___________________
Aagae Aagae Dekho hota hai kiya !!!
|
|
| |
| | | | | | | | | | | | | | | | |
