Which stage of shock is characterized by decreased blood pressure and inadequate tissue perfusion?
Irreversible stage
Refractory stage
Progressive stage
Compensatory stage
The Correct Answer is C
Choice A Reason:
The irreversible stage of shock, also known as the terminal stage, is characterized by severe organ damage and failure. At this point, the body's compensatory mechanisms have failed, and recovery is unlikely. Decreased blood pressure and inadequate tissue perfusion are present, but they are more pronounced in the progressive stage.
Choice B Reason:
The refractory stage is often used interchangeably with the irreversible stage. It signifies a point where shock has progressed to such an extent that treatment is no longer effective. The body's organs have sustained irreversible damage, and despite medical intervention, the patient is unlikely to survive.
Choice C Reason:
The progressive stage of shock is characterized by a significant drop in blood pressure and inadequate tissue perfusion. During this stage, the body's compensatory mechanisms begin to fail, leading to worsening hypoperfusion and cellular damage. This stage is critical as it marks the transition from reversible to potentially irreversible damage if not promptly treated.
Choice D Reason:
The compensatory stage, also known as the non-progressive stage, involves the body's initial response to shock. During this stage, mechanisms such as increased heart rate and vasoconstriction work to maintain blood pressure and perfusion to vital organs. Blood pressure may still be within normal limits, and tissue perfusion is maintained, albeit at a reduced level.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D","E"]
Explanation
Choice A Reason:
Cancer is a significant risk factor for DIC, particularly certain types of leukemia and metastatic cancers. Cancer can trigger DIC through the release of procoagulant substances from tumor cells, leading to widespread clotting and subsequent bleeding. The hypercoagulable state associated with malignancies increases the risk of thrombotic events, which can precipitate DIC. Patients with advanced cancer are particularly susceptible due to the aggressive nature of the disease and the body's inflammatory response.
Choice B Reason:
Sepsis is one of the most common causes of DIC. Sepsis triggers a systemic inflammatory response that activates the coagulation cascade, leading to the formation of microthrombi throughout the vasculature. This widespread clotting depletes clotting factors and platelets, resulting in a paradoxical increase in bleeding risk. The severity of sepsis correlates with the likelihood of developing DIC, making early recognition and treatment of sepsis crucial.
Choice C Reason:
Trauma can lead to DIC through extensive tissue injury and the release of tissue factor into the bloodstream. Severe trauma, such as that from major accidents or surgeries, can overwhelm the body's hemostatic mechanisms, leading to uncontrolled clotting and bleeding. The inflammatory response to trauma further exacerbates the coagulation process, increasing the risk of DIC. Prompt management of traumatic injuries and monitoring for signs of DIC are essential in these patients.
Choice D Reason:
Pregnancy complications such as placental abruption, amniotic fluid embolism, and severe preeclampsia can precipitate DIC. These conditions cause significant endothelial damage and the release of procoagulant substances, triggering the coagulation cascade. The physiological changes during pregnancy, including increased blood volume and hypercoagulability, further predispose pregnant women to DIC. Early intervention and management of pregnancy-related complications are vital to prevent DIC.
Choice E Reason:
Blood transfusion reactions can lead to DIC through immune-mediated mechanisms. Incompatible blood transfusions can cause hemolysis and the release of procoagulant substances, initiating the coagulation cascade. The resulting widespread clotting and consumption of clotting factors can lead to bleeding complications. Careful matching of blood products and monitoring for transfusion reactions are critical to prevent DIC in transfusion recipients.
Correct Answer is B
Explanation
Choice A Reason:
Blood pressure itself does not directly affect stroke volume. However, it can influence afterload, which in turn affects stroke volume. Blood pressure is the force exerted by circulating blood on the walls of blood vessels, and while it is related to cardiac function, it is not a direct determinant of stroke volume.
Choice B Reason:
Preload directly affects stroke volume. Preload refers to the degree of stretch of the cardiac muscle fibers at the end of diastole, just before contraction. It is influenced by the volume of blood returning to the heart (venous return). According to the Frank-Starling law, an increase in preload leads to an increase in stroke volume due to the enhanced force of contraction.
Choice C Reason:
Afterload also directly affects stroke volume. Afterload is the resistance the ventricles must overcome to eject blood during systole. It is influenced by factors such as arterial blood pressure and vascular resistance. An increase in afterload can decrease stroke volume because the heart has to work harder to pump blood against the higher resistance.
Choice D Reason:
Heart rate does not directly affect stroke volume. Instead, heart rate and stroke volume together determine cardiac output (CO = HR × SV). While heart rate can influence the overall amount of blood pumped by the heart per minute, it does not directly change the volume of blood ejected with each beat.
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