PHYSIOLOGY ON THE FLY: CARDIOVASCULAR PRIMER — ​LEARNER HANDOUT

Mark Tuttle 2017

Mount Desert Island Biological Laboratory

What do the following patients have in common?  62 ♂ p/w fever, cough ➔ HR 121, BP 84/61

75 ♂ p/w fatigue, dyspnea, JVD, elevated lactate ➔ HR 110, BP 110/90

74 ♀ p/w dyspnea, melena ➔ HR 110, BP 80/40

48 ♀ wheezing after eating peanuts ➔ HR 130, BP 75/40

55 ♂ w/cancer p/w dyspnea ➔ HR 120, BP 80/50

28 ♀ w/recent URI p/w dyspnea, JVD ➔ HR 140, BP 80/60

 

What is different about this scenario?  What does it have in common with the others?   What disease state encompasses all of the cases? 

By organ system, what are some signs and symptoms of end-organ hypoperfusion (shock)?  Which organ systems are most sensitive to decreased perfusion? Why? 

MarkTuttleMD.com

  PHYSIOLOGY ON THE FLY: CARDIOVASCULAR PRIMER — ​LEARNER HANDOUT

Mark Tuttle 2017

Mount Desert Island Biological Laboratory

PART 1   

Instructions​: 1. Fill out the table below. 2. For the deranged variable, be as specific as possible. 3. Propose a mechanism by which each shock subtype carries out its deleterious effects.

Case  Illness Script 

1 

62 ♂ p/w fever, cough, WBC 17,000 ➔ HR 121, BP 84/61

2 

48 ♀ wheezing after eating peanuts, hives ➔ HR 130, BP 75/40

3 

28 ♀ w/recent URI p/w dyspnea, JVD, effusion ➔ HR 140, BP 80/60

4 

55 ♂ w/cancer p/w dyspnea, CTA with PE ➔ HR 120, BP 80/50

5 

74 ♀ p/w dyspnea, melena, Hgb 5.9 g/dL ➔ HR 110, BP 80/40

6 

75 ♂ p/w fatigue, dyspnea, JVD, ↑ lactate ➔ HR 110, BP 110/90

Shock subtype  Deranged variable  Mechanism 

Treatment 

PART 2   

Instructions​: 1. For your assigned case, describe the mechanism (and specific physiologic mediators) of shock. 2. Given that the above mechanism exists in modern humans, postulate about a potential evolutionary advantage this might confer? (Ex. sickle cell trait protects against malaria infection)

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