Haemorrhage Shock And Blood Transfusion Short Question and Answer

Question 1. Types of shock.

Answer:

Various types of shock are as follows:

Question 2. Septic shock.

Answer:

Aetiology:

• Release of endotoxin by gram-negative organisms.
• Severe septicaemia.
• Peritonitis.
• Meningitis

Question 3. Neurogenic shock.

Answer:

Neurogenic Shock Causes:

• Paraplegia, quadriplegia.
• Trauma to the spinal cord.
• Spinal anaesthesia.

Neurogenic Shock Clinical Features:

• Skin remains warm, pink and well-perfused.
• Urinary output – normal.
• Heart rate-rapid.
• Blood pressure is decreased.

Question 4. Cardiogenic shock.

Answer:

Cardiogenic Shock Causes:

• Injury to heart
• Myocardial infarction.
• Cardiac arrhythmia.
• Congestive cardiac failure.

Cardiogenic Shock Clinical Features:

• Initially
  • Skin is pale and cool.
  • Urine output reduced.
• Later
  • Rapid pulse.
  • Hypotension
  • Distended neck veins.
  • The liver is enlarged.
  • The heart becomes enlarged.

Question 5. Hypovolaemic shock.

Answer:

Hypovolaemic Shock Causes:

• Blood and plasma loss
• Electrolyte loss.

Question 6. Crush Syndrome.

Answer:

Crush Syndrome

It is a symptom complex in which a portion of the body becomes crushed due to a heavy weight falling on that portion and is kept there for some time to crush all the tissues in that portion.

Crush Syndrome Causes:

• Earthquakes
• Mine injuries
• Air raids
• Collapse of building.
• Use of tourniquet for a longer period.

Crush Syndrome Clinical Features:

• Extravasaion of blood into muscles.
• Muscles are crushed and swollen.
• Acute renal tubular necrosis.
• Reduced urinary output.
• Tense and painful extremities.

Crush Syndrome Treatment:

• Application of tourniquet.
• Parallel incisions are made to relieve tension.
• Administration of intravenous fluid.
• Catheterization of bladder.
• Hemodialysis is a severe condition.

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Question 7. Hypokalaemia.

Answer:

Hypokalaemia

Potassium deficiency in diet is called hypokalemia.

Hypokalaemia Causes:

• Following trauma.
  • Starvation
  • Loss of gastrointestinal secretion.

Hypokalaemia Clinical features:

• Gradual onset of drowsiness.
• Slow and slurred speech.
• Irritability.
• Muscular hypotonia and weakness.
• Absence of deep reflexes.
• Slow pulse rate.
• Diminished intestinal motility.
• Low BP.
• Skin remains warm and dry.

Hypokalaemia Treatment:

• Replacement of potassium deficit.

Question 8. Acidosis.

Answer:

Acidosis

An increase in pH leads to acidosis.

Acidosis Types:

1. Metabolic acidosis.
   • In it, there is a gain or retention of fixed acids or loss of base.
   • Cause:
     • Diabetic acidosis.
     • Lactic acidosis.
     • Renal insufficiency.
     • Rapid transfusion of bank blood.
     • Diarrhoea.
   • Clinical Features:
     • Increase in rate and depth of breathing.
     • Rapid and noisy respiration.
     • Raised pulse rate and blood pressure.
     • Urine becomes strongly acidic.
   • Treatment:
     • Administration of ringer’s lactate solution.
2. Respiratory acidosis.
   • Causes:
     • Lung disorders.
     • Peritonitis
     • Crush injury.
     • Depressed respiratory centre.
     • Airway obstruction.

Acidosis Clinical Features:

• Slow rise in BP.
• Abnormal respiration.
• Restlessness.
• Hypertension
• Tachycardia.

Acidosis Treatment:

• Mechanical ventilation
• Endotracheal intubation.
• Avoid over-sedation and over-use of muscle relaxants.

Question 9. Haemorrhage.

Answer:

Haemorrhage

Haemorrhage is defined as the escape of blood from blood vessels.

Haemorrhage Classification:

1. Based on the bleeding haemorrhage.
   • External and internal.
   • Arterial, venous or capillary.
2. Based on the time of appearance.
   • Primary – Secondary – Reactionary.

Question 10. Secondary Haemorrhage.

Answer:

Secondary Haemorrhage

It is a bleeding that occurs usually after 7-14 days of injury.

Secondary Haemorrhage Causes:

• Infection.
• Sloughing part of the arterial wall.

Secondary Haemorrhage Clinical features:

• Preceded by warning haemorrhage staining the dressings.
• Followed by moderate to severe haemorrhages.

Secondary Haemorrhage Types:

• Externally – example: at operation site of haemorrhoids- tomy.
• Internally Example: haematemesis following peptic ulcer operation.

Question 11. Hemophilia.

Answer:

Hemophilia

Hemophilia is an X-linked recessive disorder of coagulation factors.

Hemophilia Types:

1. Hemophilia A-classic haemophilia – due to factor 8 deficiency.
2. Hemophilia B-Christmas disease -due to factor 9 deficiency.
3. Von Willebrand’s disease due to deficiency of von Willebrand factor.

Hemophilia Clinical features:

• Easy bruising
• Prolonged bleeding.
• Spontaneous bleeding into subcutaneous tissue.
• GIT bleeding.
• Hpitaxis.
• Recurrent haemarthrosis.
• Hematuria.
• Intracranial haemorrhage.

Question 12. Disseminated intravascular coagulation (DTC)

Answer:

Disseminated intravascular coagulation (DTC)

Disseminated intravascular coagulation is a complex thrombo-hemorrhagic disorder occurring as a secondary complication in some systemic diseases.

Pathogenesis:

• Includes

1. Activation of coagulation
2. Thrombotic phase
3. Consumption phase.
4. Secondary fibrinolysis.

Question 13. Blood groups.

Answer:

Blood groups

Blood groups are classified based on the presence or absence of specific agglutinogen or antigen on the surface of RBC.

Major blood groups are:

1. ABO system

2. Rh blood group.

• • Rh factor is an antigen present in RBC.
  • Persons having D antigen are called Rh-positive.

Question 14. Rh factor.

Answer:

Rh factor

• Rh factor is an antigen present in RBC.
• It was first discovered by Landsteiner and Weiner in rhesus monkey.
• It is detected only in RBCs
• It is inherited from both parents as homozygous positive DD, heterozygous negative Dd or homozygous negative dd.
• Rh Antibody is absent in plasma.
• But its production can be evoked by.
  • Transfusion with Rh-positive blood.
  • Entrance of Rh-positive blood from foetus into circulation of Rh-negative mother.

Question 15. Blood Transfusion.

Answer:

Blood Transfusion

It is a process of transferring blood or blood-based products from one person into the circulatory system of another.

Blood Transfusion Types:

1. Typical stored CPD blood from the blood bank.
2. Filtered blood-filtered through a membrane with 40 |im pores.
3. Warm blood is used in cardiopulmonary operations.
4. Autotransfusion – preserving and then transfusing one’s blood.
5. Replacement transfusion – used in newborns.

Question 16. Indications of blood transfusion.

Answer:

Acute haemorrhage.

• During operations, preoperatively and postoperatively.
• Anaemia.
• Malnutrition.
• In severe burns.
• In coagulation disorders.
• In erythroblastosis fetalis.
• During chemotherapy.

Question 17. Complications of blood transfusion.

Answer:

Complications of blood transfusion

1. Transfusion reactions
   • Incompatibility
   • Pyrexia reactions
   • Allergic reactions
   • Sensitisation to leucocytes and platelets
2. Transmission of diseases
   • Serum hepatitis
   • AIDS
3. Reactions caused by massive transfusion.
   • Acid-base imbalance.
   • Hyperkalaemia.
   • Citrate toxicity.
   • Hypothermia.
   • Failure of coagulation.
4. Complication of over-transfusion.
   • Congestive cardiac failure.
5. Other complications.
   • Thrombophlebitis
   • Air embolism.

Question 18. Types of haemorrhage

Answer:

Types of haemorrhage

1. According to the source
   • External haemorrhage – seen externally
   • Internal haemorrhage – not seen externally
2. According to the vessels involved
   • Arterial haemorrhage – haemorrhage coming out of the artery
   • Venous haemorrhage – haemorrhage coming out of vein
   • Capillary haemorrhage – haemorrhage coming out of the capillary
3. According to the time of appearance
   • Primary haemorrhage – at the time of injury
   • Reactionary haemorrhage – within 24 hours of injury
   • Secondary haemorrhage – after 7-14 days of injury

Question 19. Reactions to blood transfusion

Answer:

Reactions to blood transfusion