Shock XP

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com/user/DrRabiulHaque
Dr. Rabiul Haque

Lecturer,
Department of Pathology,
Holy Family Red Crescent Medical College,
Dhaka
www.youtube.com/user/DrRabiulHaque
Topics Overview
Definition of Shock
Types of Shock & Their Causes / Mechanisms
Septic Shock
Pathogenesis of Septic Shock
Stages of Shock
What is shock ?
What is shock ?
It is a state characterized by systemic
hypotension.
What is shock ?
hypotension.
It can occur due to diminished cardiac output
or due to reduced effective circulating blood
volume.
What is shock ?
hypotension.
volume.
What is shock ?
hypotension.
volume.
What is shock ?
hypotension.
volume.
It results in impaired perfusion of tissue and
cellular hypoxia.
What is shock ?
hypotension.
It can occur due to diminished cardiac output or
due to reduced effective circulating blood
volume.
It results in impaired perfusion of tissue and
cellular hypoxia.
At the onset of shock, cellular injury is reversible.
What is shock ?
It is a state characterized by systemic hypotension.
It can occur due to diminished cardiac output or due
to reduced effective circulating blood volume.

It results in impaired perfusion of tissue and cellular
hypoxia.
At the onset of shock, cellular injury is reversible.
Prolonged shock can cause irreversible cellular injury
and can be fatal.
Definition
Stay Calm & Look At The

Teddy !
Definition
Shock is a state in which diminished cardiac
output or reduced effective circulating blood

volume impairs tissue perfusion and leads to
cellular hypoxia.
- Ref. Robbins & Cortan Pathologic Basis Of Disease 9th Edition
Definition
Shock is a state in which diminished cardiac output or
reduced effective circulating blood volume impairs

tissue perfusion and leads to cellular hypoxia.
- Ref. Robbins & Cortan Pathologic Basis Of Disease 9 th Edition
Shock is characterized by systemic hypotension due to
either reduced cardiac output or due to reduced

effective circulating blood volume. The consequences
are impaired tissue perfusion and cellular hypoxia.
Ref. Robbins & Cortan Pathologic Basis Of Disease 8th Edition

General Categories
General Categories
Three General Categories:
Cardiogenic Shock
Hypovolemic Shock
Shock Associated With Systemic Inflammation
Less Common
Neurogenic Shock
Anaphylactic Shock
Causes of Cardiogenic
Shock
i) Intrinsic Causes Or Deficient Emptying:

a) Myocardial infarction
b) Cardiac Arrhythmias
c) Cardiomyopathies
d) Rupture of the heart, ventricle or papillary muscle
ii) Extrinsic Compression Or Deficient Filling:
a) Cardiac Tamponade from haemopericardium
iii) Obstruction to the outflow e.g.
a) Pulmonary Embolism
b) Ball Valve Thrombus
c) Tension Pneumothorax
d) Dissecting Aortic Aneurysm
Shock

c) Cardiomyopathies
Shock

c) Cardiomyopathies
Shock

c) Cardiomyopathies
Shock

c) Cardiomyopathies
Shock

c) Cardiomyopathies
Causes Of Hypovolemic
i) Acute haemorrhage
Shock
ii) Dehydration from vomiting, diarrhoea
iii) Burns
iv) Acute pancreatitis
v) Excessive use of diuretics
Shock Associated With Systemic

Inflammation
Shock
With Systemic
Release of Associated
Inflammatory
Mediators
Inflammation
Arterial vasodilation
Vascular leakage
Venous pooling of blood
Organ Failure
Death
Tissue
Hypoperfusion
Cellular Hypoxia
Metabolic Derangement
Organ Dysfunction
General Categories
Three General Categories:
Cardiogenic Shock
Hypovolemic Shock
Shock Associated With Systemic Inflammation
Less Common
Neurogenic Shock
Anaphylactic Shock
Septic Shock
Septic Shock
The old synonym Endotoxic Shock is no
longer an appropriate term.
Pathogenesis Of Septic
Shock
Pathogenesis of Septic
Shock
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Teddy !
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Shock
Shock
Shock
Shock
Shock
Shock
Shock
Shock
Shock
Shock
Shock
Shock
Metabolic Alterations In Septic

Shock
Insulin resistance : By impaired surface
expression of GLUT 4 glucose transporter

Shock
Hyperglycemia

Shock
Hyperglycemia
Gluconeogenesis

Shock
Hyperglycemia
Gluconeogenesis
Lactic Acidosis
Shock

Shock
Hyperglycemia
Gluconeogenesis
Lactic Acidosis
Stages of Shock
Stages of Shock
Nonprogressive Phase
Progressive Stage
Irreversible Stage
Stages of Shock
Progressive Stage
Irreversible Stage
Peripheral
vasoconstriction
Tachycardia
Renal conservation of
fluid
Stages of Shock
Progressive Stage
Irreversible Stage
Peripheral
vasoconstriction
Tachycardia
Renal conservation of
fluid
Stages of Shock
Progressive Stage
Irreversible Stage
Stages of Shock
Progressive Stage
Irreversible Stage
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Dr. Rabiul Haque

to reduced effective circulating blood volume.

Stay Calm & Look At The

output or reduced effective circulating blood

reduced effective circulating blood volume impairs

- Ref. Robbins & Cortan Pathologic Basis Of Disease 9 th Edition

Shock is characterized by systemic hypotension due to

either reduced cardiac output or due to reduced

Ref. Robbins & Cortan Pathologic Basis Of Disease 8th Edition

i) Intrinsic Causes Or Deficient Emptying:

i) Intrinsic Causes Or Deficient Emptying:

i) Intrinsic Causes Or Deficient Emptying:

i) Intrinsic Causes Or Deficient Emptying:

i) Intrinsic Causes Or Deficient Emptying:

i) Intrinsic Causes Or Deficient Emptying:

Shock Associated With Systemic

longer an appropriate term.

Stay Calm & Look At The

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Metabolic Alterations In Septic

Metabolic Alterations In Septic

Metabolic Alterations In Septic

Metabolic Alterations In Septic

Metabolic Alterations In Septic

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