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Lecture 10

BIMS 201 Lecture Notes - Lecture 10: Hypovolemia, Cardiogenic Shock, Syndrome Of Inappropriate Antidiuretic Hormone Secretion


Department
Biomedical Science
Course Code
BIMS 201
Professor
Elizabeth A.Crouch
Lecture
10

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Hypovolemic Shock
When our body loss the:
i)Whole blood (due to fracture of the long bone,ruptured of pelvic venous plexure,intra-abdominal
injury,APH,PPH,GI bleed…)
ii)Plasma(due to burn)
iii)Extracellular fluid(due to vomiting,diarrhea)
How the body cope with that?
1)Decrease urine output (Normal -1.5L/day) 50cc/hour600cc/day
Hypovolemia will get oliguria
-to optimized tissue perfusion to Brain,Heart,Kidney
2)Plasma K+ will increase
Cardiogenic Shock
treat with inotrope except Right Ventricular Infarction (Give fluid)
Haemodynamic Accessment
-access pulse rate,BP,urine output,Central Venous Pressure
CVP: will reduce in cardiogenic shock,but increase in hypovolemic shock
Common cause of Tachycardia
-Anxiety
-Pain
-Fever
-Hypovolemia
In case of dehydration until reduce urine output,1st approach is to rehydrate them.
5-10% will have regain urine outputThen only give furesemide .
Remaining will develop the AKI despite of those approach.
DKA and HONK
some differences to be remember:
1)DKA more common in younger age group,HONK more in older age group
2)Onset of DKA is few days,HONK normally will be more than 1 week
3)DKA patients will present to hospital earlier unlike those HONK patients,which will present late to
hospital and more ill looking.
4 Exceptions(Hypotension but still
polyuria)
DKA
HONK
2 more rarer causes:Diabetes
insipidus,SIADH
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