General Patholog

A. Case Study: A 40 year old patient got a car accident and he was found to have
femoral shaft fracture and then he suddenly developed dyspnea, cyanosis, and
shock and passed away immediately after surgery. There was no massive blood
loss at the time of trauma or during surgery. What is the probable cause of
death? Explain.

 The probable cause of death is shock and fat embolism. The reason behind this
is that hypovolemic or traumatic shock may occur due to crucial damaged on
extremities resulting to hemmorhage. Based on the case the patient suffers
from femoral shaft fracture which then resulted to developing dyspnea,
cyanosis. We all know that bone is a very vascular body structure, a fracture
can lead to lost of large quantity of blood. However according to the case,
there was no massive blood loss at the time of trauma which could be because
there is no external lesion which then resulted to blood accumulation to the
site of fracture. Due to the femoral fracture of the patient, it allows marrow
contents (fats) out into the circulation. Possibly this resulted to obstruction of
the arteries from the brain or the lungs.
 Dyspnea, or the shortness of breath of the patient resulted to cyanosis
because there is a poor supply of oxygen throughout the body.

B. Discuss the causes of hypovolemic and cardiogenic shock.

HYPOVOLEMIC SHOCK CARDIOGENIC SHOCK

- This is shocked caused by reduced
blood volume. This type of shock causes:
haemorrhage, diarrhea and vomiting,
burns, trauma, and the like.
This is shock that results from severe
depression of cardiac performance. It
primarily results from pump failure. This
type of shock causes: myopathic and
mechanical.

Haemorrhage- Due to oxygen Myophatic causes of cardiogenic shock

deprivation, endothelial cell apoptosis is includes the following: acute myocardial
induced following hypovolemic shock. infraction, mycocarditis, dilated
Most often, hypovolemic shock is cardiomyopathy/hypertrophic
secondary to rapid blood loss. cardiomyopathy, and myocardial
depression in septic shock.
Diarrhea and vomiting- It is also possible
to get hypovolemic shock from losing a Mechanical is divided into two:
large amount of fluids after a lot of Intracardiac and Extracardiac.
diarrhea, throwing up or sweating. Intracardiac involves the following: left
ventricle outflow obstruction, reduction
Burns- it results form the interplay of in forward cardiac output, and
direct tissue injury, hypovolemia, and the arrhythmia. Under extracardiac, it
release of multiple mediators of involves the following: pericardial
inflammation, with effects on both the temponade, tension pneumothorax,
microcirculation and the function of the
heart and lungs. acute massive pulumunary
hypertension,a and sever pulumunary
hypertension.