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Septic shock
5%
2/37
Hypovolemic shock
81%
30/37
Anaphylactic shock
0%
0/37
Neurogenic shock
3%
1/37
Cardiogenic shock
8%
3/37
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This patient presents with physical exam findings and vascular parameters consistent with hypovolemic shock. Hypovolemic shock in a young patient is generally secondary to bleeding. Individuals may hemorrhage large quantities of blood into the thorax, abdomen, retroperitoneum, pelvis, thigh and external environment. Characteristic physical examination findings include flat neck veins, cool extremities, pallor, delayed capillary refill time, and others. Cardiac index and PCWP are low, while systemic vascular resistance is elevated. Mtaweh et al. review the management of shock. Depending on the degree of hemodynamic instability in hemorrhagic shock, fluid resuscitation can be started with crystalloids. Achieving hemostasis with crystalloids or blood transfusions are the primary goals of care. Wang et al. review hypovolemic shock. Selective vasoconstriction due to adrenaline, noradrenaline, angiotensin II, and antidiuretic hormone helps ensure adequate perfusion of the brain and the heart in compensated hypovolemic shock. Hypovolemic shock is termed decompensated when these measure fail to provide adequate organ perfusion. Incorrect Answers: Answers 1, 3, and 4: Septic and anaphylactic shock produce a high cardiac index with a low PCWP and low vascular resistance. Neurogenic shock produces a low cardiac index, PCWP, and vascular resistance. Answer 5: Cardiogenic shock produces a low cardiac index with a high PCWP and high systemic vascular resistance.
3.8
(5)
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