Dale Fremore was back home after spending the day at a picnic where he ate some
ID: 3523777 • Letter: D
Question
Dale Fremore was back home after spending the day at a picnic where he ate some "spoiled" potato salad. He developed severe abdominal pain and cramps, vomiting, and diarrhea. After about 10-12 episodes of watery diarrhea, Mr. Fremore became so pale and weak he could hardly walk. His wife took him to the hospital where he was diagnosed with severe dehydration (decreased plasma volume). Mr. Fremore was suffering from shock. Explain what happens to cardiac output, urine output, pulse pressure and blood pressure of Mr. Fremore. Would the respiratory system be affected and if so, how? Would the immune system be activated, why or why not?
Explanation / Answer
Shock due to generation is known as hypovolemic shock where intravascular volume is reduced. It means that plasma volume is reduced due to shock. As plasma volume is reduced heart receives less blood than normal and as a result, cardiac output is reduced.
As the intravascular blood volume is reduced so the cardiac output. Low cardiac output results in hypoperfusion of the kidney. As a result urine output decreases.
Pulse pressure is defined as the difference between systolic and diastolic pressure. In hypovolemic shock, there is an absolute reduction of intravascular volume so preload is reduced. As there is hypovolemia, arteries constrict to maintain blood flow into vital organs, so diastolic pressure remains normal or near normal. So the systolic pressure is reduced due to low cardiac output but diastolic pressure does not lower much due to vasoconstriction mechanism. So pulse pressure reduces.
As the cardiac output is reduced there is less blood supply to the vital organs like brain, kidney. This is sensed by a chemoreceptor mechanism.So there is an increased respiratory rate as a result of sympathetic system activation by the CNS.
Hypovolemic shock cause hypoperfusion, it causes hypoxia which causes tissue injury. As a result, innate immunity is activated ( complement system and other immune cells activation)
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