Contributing Factors to Circulatory Shock
Mr. X, age 57, presented to his physician with marked fatigue, nausea with occasional diarrhea, and a sore, swollen tongue. Lately he also has been experiencing a tingling feeling in his toes and a feeling of clumsiness. Microscopic examination of a blood sample indicated a reduced number of erythrocytes, many of which are megaloblasts, and a reduced number of leukocytes, including many large, hypersegmented cells. Hemoglobin and serum levels of vitamin B12 were below normal. Additional tests confirm pernicious anemia.
Discussion Questions
Relate the pathophysiology of pernicious anemia to the manifestations listed above.
Discuss how the gastric abnormalities contribute to vitamin B12 and iron deficiency and how vitamin B12 deficiency causes complications associated with pernicious anemia.
Discuss other tests that could be performed to diagnose this type of anemia.
Discuss the treatment available and the limitations.
Ms. L, a 19-year-old woman with no previous medical history, was involved in a serious automobile accident in which her best friend died. Examination by EMT personnel first on the scene revealed she had only minor scrapes and bruises and no sign of head trauma. While en route by ambulance to the hospital, Ms. L complained of thirst and appeared restless. Further examination indicated a rapid pulse and respirations, with her blood pressure now at 100/60 mm Hg. She appeared less responsive to the paramedics. She was slipping into circulatory shock as they checked her again for internal injuries.
Discussion Questions
Discuss the contributing factors to shock in this case and the pathophysiologic changes causing the changes in vital signs.
Discuss the signs and symptoms of shock, including the rationale for each, as seen in the early stage, and as compensation mechanisms respond.
Discuss emergency and follow-up treatment for shock and for complications that may arise if not treated quickly.
Compare the types of shock, giving a specific cause, classification, and any significant changes in onset or manifestations.
Discussion
Student Full Name
Institutional Affiliation
Course Full Title
Instructor Full Name
Due Date
Discussion
Case Study
Ms. L, a 19-year-old woman with no previous medical history, was involved in a serious automobile accident in which her best friend died. Examination by EMT personnel first on the scene revealed minor scrapes and bruises with no sign of head trauma. However, while en route to the hospital, the patient complained of thirst and demonstrated symptoms of restlessness, rapid pulse and respiration, low blood pressure (100/60 mm HG), and unresponsiveness.
Initial Discussion
Ms. L. presents to the hospital with possible circulatory shock as evidenced by rapid breathing, rapid heartbeat, loss of consciousness, and low blood pressure. These symptoms result from problems with the circulatory system, such as the patient’s heart suddenly failing to pump oxygen-rich blood to the body after a heart attack. Some of the reasons for the circulatory shock include damage of the left ventricle or right ventricle; bleeding, pulmonary embolism; endocarditis; pericardial tamponade; or even arrhythmias.
Treatment and Complications
Circulatory shock requires emergency treatment to restore circulatory flow to the major organs. However, treatment is based on the underlying cause established through physical examination and laboratory tests. Some of the complications that may arise include loss of breathing, fall in body temperature, and loss of blood pressure, all of which often result in death if not addressed promptly. The first type of shock is hypovolemic shock, which is caused by insufficient circulating volume owing to severe diarrhea or vomiting as well as hemorrhage. The second type of shock is cardiogenic shock, which is caused by heart failure either due to myocardial infarction, dysrhythmia, cardiac valve problems, or congestive heart failure (Kohli, 2020). The third type of shock is obstructive shock and is caused by blockage of blood flow outside of the heart. Th...