Dr. Gerald Diaz @GeraldMD
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Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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Shock Classification
Shock Definition: State of cellular and tissue hypoxia due to: reduced oxygen delivery, increased oxygen
Shock Classification ... • Most common type ... #Classification ... #Types #diagnosis ... warm #wet #dry #table
Shock - Differential Diagnosis by Classification

Hypovolemic (Intravascular volume depletion)
 - Hemorrhagic 
   • Trauma
Diagnosis by Classification ... Anaphylaxis - Spinal cord ... exacerbation (any cause ... Differential #Diagnosis #Classification ... #Table #CriticalCare
Reflex Testing - Causes of Hyporeflexia and Hyperreflexia
Focal Hyporeflexia: 
 • Radiculopathy, Mononeuropathy, Polyneuropathy, Acute stroke,
Reflex Testing - ... Causes of Hyporeflexia ... polyneuropathy (e.g ... Hyperreflexia #Testing ... #diagnosis #table
Hypokalemia - Differential Diagnosis
Poor Intake 
 - Starvation
 - Anorexia
GI Losses 
 - Vomiting / NG
and 2, but not type ... 4) - Salt wasting ... Low #Potassium #Table ... #Classification ... #Causes
Shock Overview
A state of tissue hypoxia due to decreased or dysregulated oxygen delivery or extraction, resulting
oliguria (< 0.5 mL/kg ... Ext: warm vs. cold ... #Classification ... #differential #causes ... #classification
Shock Overview
A state of tissue hypoxia due to decreased or dysregulated oxygen delivery or extraction, resulting
oliguria (< 0.5 mL/kg ... Ext: warm vs. cold ... #Classification ... #differential #causes ... #classification
Common Vasopressors and Inotropes
Norepinephrine (NE)
 - Indication: Distributive shock (1st line for septic shock), Cardiogenic shock
is not desired (e.g ... is not desired (e.g ... Bradyarrhythmias, Some cases ... be used in all types ... Inotropes #comparison #table
Shock - Differential Diagnosis by Classification
Reflex Syncope 
 - Vasovagal syncope
   • Prolonged standing
Shock - Differential ... Diagnosis by Classification ... Medication side effect (e.g ... Differential #Diagnosis #Classification ... #Table #Causes
Cardiac Stress Testing
Exercise:
 • Everyone who can exercise should!
 • They must be able to raise
Cardiac Stress Testing ... • They must be able ... production to cause ... pts with severe COPD ... arrythmias Diagnostics: EKG
Hyponatremia - Differential Diagnosis by Mechanism
Decr Blood Pressure (“Decr Effective Circulating Volume”) 
 - Volume depletion
- Malignancy (e.g ... . pneumonia, COPD ... Cerebral salt wasting ... Differential #Diagnosis #Table ... #Causes #Sodium