Deck 48: Shock, Multiple Organ Dysfunction Syndrome, and Burns in Adults

Question 1

In multiple organ dysfunction syndrome (MODS),the gut hypothesis attempts to explain which phenomena?

A) Paralytic ileus
B) Translocation of bacteria
C) Maldistribution of blood flow
D) Massive diarrhea accompanying septic shock

Answer 1

Translocation of bacteria

Question 2

For which type of shock would antihistamines and corticosteroids be prescribed?

A) Septic
B) Anaphylactic
C) Hypovolemic
D) Cardiogenic

Answer 2

Anaphylactic

Question 3

Which fluid is most often used in fluid resuscitation after a major burn injury?

A) Saline
B) Albumin
C) Lactated Ringer solution
D) Dextrose in water

Answer 3

Lactated Ringer solution

Question 4

What stimulates the respiratory burst and production of highly toxic free radicals in the multiple organ dysfunction syndrome (MODS)?

A) Neutrophils adhering to the endothelium
B) Activation of the complement cascade
C) Release of prostaglandins, thromboxanes, and leukotrienes
D) Activation of the fibrinolytic system

Question 5

Which form of shock occurs from an acute burn injury?

A) Hypovolemic
B) Septic
C) Cardiogenic
D) Vasogenic

Question 6

What type of shock develops as a result of the overstimulation of the parasympathetic nervous system or the understimulation of the sympathetic nervous system?

A) Septic
B) Cardiogenic
C) Anaphylactic
D) Vasogenic

Question 7

The release of catecholamine by the adrenal glands compensate for which initial effects of hypovolemic shock?

A) Interstitial fluid moves out of the vascular compartment.
B) Systemic vascular resistance is decreased.
C) Heart rate is increased.
D) Water excretion is increased.

Question 8

What mechanism causes organ injury in primary multiple organ dysfunction syndrome (MODS)?

A) Impaired immune response
B) Impaired glucose use
C) Impaired perfusion
D) Impaired ventilation

Question 9

What is the final outcome of impaired cellular metabolism?

A) Cellular alterations in the heart and brain
B) Buildup of cellular waste products
C) Cellular alterations in the vasculature structures and kidneys
D) Impairment of urine excretion

Question 10

In secondary multiple organ dysfunction syndrome (MODS),what stimulates the normal endothelial cells to change to a proinflammatory state?

A) Interleukin (IL)-4 (IL-4) and IL-13
B) IL-1, IL-6, and tumor necrosis factor (TNF)
C) Interferon gamma (IFN-g) and granulocyte cell-stimulating factor
D) Prostaglandin, leukotrienes, histamine, and bradykinin

Question 11

Hypovolemic shock begins to develop when intravascular volume has decreased by what percentage?

A) 5
B) 10
C) 15
D) 20

Question 12

Which form of shock is often more severe than other forms because of its sudden,rapid systemic vasodilation?

A) Septic
B) Hypovolemic
C) Anaphylactic
D) Neurogenic

Question 13

Blistering of the skin within minutes occurs in which type of burn injury?

A) First degree
B) Superficial second degree
C) Deep second degree
D) Third degree

Question 14

What is the clinical hallmark of neurogenic shock as a result of the overstimulation of the parasympathetic nervous system?

A) Vasoconstriction
B) Vasodilation
C) Increased metabolism
D) Respiratory distress

Question 15

What type of shock is related to a decrease in systemic vascular resistance?

A) Septic
B) Cardiogenic
C) Hypovolemic
D) Heart failure

Question 16

Which condition is best defined as a clinical syndrome involving a systemic response to infection,which is manifested by two or more of the systemic inflammatory response syndrome criteria?

A) Bacteremia
B) Sepsis
C) Septicemia
D) Septic shock

Question 17

The endpoint of burn shock is defined as the time when the individual is able to do which of the following?

A) Maintain adequate blood pressure for 4 hours.
B) Maintain adequate urine output for 2 hours.
C) Manage pain without narcotics.
D) Manage pain during dressing changes.

Question 18

In septic shock,which mediators are antiinflammatory?

A) Interleukin (IL)-4 (IL-4), IL-10, and IL-13
B) Tumor necrosis factor-alpha (TNF-a) and granulocyte cell-stimulating factor
C) IL-1, IL-2, and IL-6
D) Prostaglandin, leukotrienes, and bradykinin

Question 19

Which clinical manifestation of septic shock confirms an elevation in immune system response?

A) Tachycardia
B) Increased white blood cell count
C) Low respiratory rate
D) Hypothermia

Question 20

What is the most reliable criterion of adequate fluid resuscitation after a major burn injury?

A) Blood pressure
B) Pulse rate
C) Respiratory rate
D) Urine output

Question 21

How many milliliters of fluid replacement per hour does a 70-kg adult with a 50% total body surface area burn and a body surface area of 2 m require?

A) 150
B) 275
C) 350
D) 500

Question 22

Match the types of shock with the corresponding descriptions.Terms can be used more than once.
Follows widespread hypersensitivity reaction.

A)Cardiogenic
B)Hypovolemic
C)Neurogenic
D)Anaphylactic
E)Septic

Question 23

What is the purpose of monitoring procalcitonin (PCT)levels in a patient after a burn?

A) To help evaluate the potential risk for respiratory complications
B) To justify the initiation of antibiotic therapy
C) To determine when discontinuing antibiotic use is feasible
D) To help in the selection of appropriate antibiotic therapy agents

Question 24

Daily evaporative water loss after a burn injury is approximately how many times the normal?

A) 5
B) 10
C) 15
D) 20

Question 25

Match the types of shock with the corresponding descriptions.Terms can be used more than once.
Follows major burns.

A)Cardiogenic
B)Hypovolemic
C)Neurogenic
D)Anaphylactic
E)Septic

Question 26

Match the types of shock with the corresponding descriptions.Terms can be used more than once.
Follows parasympathetic stimulation.

A)Cardiogenic
B)Hypovolemic
C)Neurogenic
D)Anaphylactic
E)Septic

Question 27

What effect does a fatal burn injury have on interleukins (ILs)?

A) Decreases levels of IL-2, which may decrease T helper 1 (Th1) lymphocytes.
B) Decreases levels of IL-4, which causes a shift in production from Th1 to Th2 lymphocytes.
C) Decreases levels of IL-6, which produces cytokines.
D) Decreases levels of IL-12, which stimulates the production of immunoglobulins.

Question 28

Match the types of shock with the corresponding descriptions.Terms can be used more than once.
Follows myocardial infarction.

A)Cardiogenic
B)Hypovolemic
C)Neurogenic
D)Anaphylactic
E)Septic

Question 29

Which feedback loop will further impair oxygen in all types of shock? (Select all that apply.)

A) Activation of the fibrinolytic cascade
B) Increased circulating volume
C) Hypermetabolic state
D) Lysosomal enzyme release
E) Activation of the clotting cascade

Question 30

Which condition does a burn injury create for an extended period?

A) Hypervolemia
B) Hypermetabolism
C) Hyponatremia
D) Hypotension

Question 31

A patient will be referred to the burn unit when which criteria are met? (Select all that apply.)

A) Patient is older than 5 years of age.
B) The burn involves the face or a major joint.
C) The source of the burn is electrical.
D) Partial thickness burns are on more than 10% of the total body surface area (TBSA).
E) Patient has a life-threatening trauma injury.

Question 32

What is the significance of a high level of interleukin 1 (IL-1)in a patient who has experienced severe burns?

A) Prognosis is poor.
B) Antibiotic therapy is required.
C) Urinary function is improved.
D) They are less at risk for death.

Question 33

Match the types of shock with the corresponding descriptions.Terms can be used more than once.
Follows a systemic inflammatory response.

A)Cardiogenic
B)Hypovolemic
C)Neurogenic
D)Anaphylactic
E)Septic