metabolik dan endokrin respon terhadap pembedahan anak.pptx
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The document discusses the endocrine and metabolic responses to surgery. It describes the "ebb phase" that occurs immediately after trauma, bringing hypovolemic shock and decreased energy. The "flow phase" then follows, restoring tissue perfusion but inducing a hypermetabolic state with hyperglycemia and hyperthermia. The document recommends strategies like fluid replacement and antibiotics for the ebb phase, and nutritional support and mobilization for the flow phase, to attenuate the metabolic response to surgery.
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Respon endokrin dan metabolik terhadap trauma
The document discusses the endocrine and metabolic response to trauma. It notes that trauma causes a stress response involving the hypothalamus, pituitary, and adrenal glands. This leads to two phases - an initial "ebb phase" with shock and decreased energy, followed by a "flow phase" with restored circulation and a hypermetabolic state. Strategies are described to attenuate the metabolic response during each phase through fluid replacement, oxygen, nutrition support, and preventing complications.
Metabolic response to trauma
The document discusses the metabolic response that occurs following injury or trauma to the body. It describes how there is an initial ebb phase characterized by shock, followed by a longer flow phase with increased metabolism and hormone levels. The metabolic response aims to restore homeostasis but can also cause organ damage. Factors like infection, nutrition, and inflammation can modify this response. Managing the response through fluid resuscitation, oxygen delivery, and minimizing stressors can improve outcomes.
Metabolic response to injury
Stress response caused by events such as surgical trauma includes endocrine, metabolic and immunological changes. Stress hormones and cytokines play a role in these reactions. More reactions are induced by greater stress, ultimately leading to greater catabolic effects. Cuthbertson reported the characteristic response that occurs in trauma patients: protein and fat consumption and protection of body fluids and electrolytes because of hypermetabolism in the early period. The oxygen and energy requirement increases in proportion to the severity of trauma. The awareness of alterations in amino acid, lipid, and carbohydrate metabolism changes in surgical patients is important in determining metabolic and nutritional support. The main metabolic change in response to injury that leads to a series of reactions is the reduction of the normal anabolic effect of insulin, i.e. the development of insulin resistance. Free fatty acids are primary sources of energy after trauma. Triglycerides meet 50 to 80 % of the consumed energy after trauma and in critical illness. Surgical stress and trauma result in a reduction in protein synthesis and moderate protein degradation. Severe trauma, burns and sepsis result in increased protein degradation. The aim of glucose administration to surgical patients during fasting is to reduce proteolysis and to prevent loss of muscle mass. In major stress such as sepsis and trauma, it is important both to reduce the catabolic response that is the key to faster healing after surgery and to obtain a balanced metabolism in the shortest possible time with minimum loss. For these reasons, the details of metabolic response to trauma should be known in managing these situations and patients should be treated accordingly
Metabolic response to trauma
The document discusses the metabolic response to trauma and injury. It begins by outlining the objectives of understanding the metabolic response and how it can be minimized through elective or emergency surgical procedures. It then describes the physiological changes that occur such as increases in temperature, heart rate, and metabolic rate. These changes are mediated by the neuroendocrine stress response and proinflammatory cytokines. The document outlines the ebb and flow phases of metabolic response, describing the catabolic effects in the ebb phase and hypermetabolic effects in the flow phase. Key aspects of the metabolic response include hypermetabolism, insulin resistance, protein catabolism, and changes in body composition. Methods to minimize the metabolic response include fluid resuscitation, oxygen
Relationship between trauma and diseases
The document discusses the relationship between trauma and diseases. It covers several key points:
1) Trauma can indirectly impact diseases by activating or accelerating latent conditions, especially if accompanied by infection, reduced exercise, weight gain or overeating.
2) Major injuries are associated with an inflammatory response that can lead to multiple organ failure and death if not properly treated.
3) The metabolic response to trauma involves neuroendocrine and immune system changes that mobilize energy stores and substrates. This response aims to aid recovery but can damage distant organs if severe.
4) Specific diseases that can be impacted by trauma include post-traumatic stress disorder, diabetes, rhabdomyolysis (muscle breakdown),
Homeostasis, the internal milieu of the human body
This document discusses homeostasis and the body's response to injury. It covers several key points:
1. Homeostasis refers to maintaining a constant internal environment. The body has complex coordinated physiological processes to maintain homeostasis.
2. Following major trauma or sepsis, the body exhibits a systemic inflammatory response and loses homeostasis. Medical intervention is needed to return the patient to homeostasis.
3. The response to injury is graded - more severe injuries cause a greater physiological and immunological response. This includes fever, increased metabolism and catabolism.
4. Several factors mediate the metabolic response, including neuroendocrine hormones and cytokines. The response aims to provide substrates for survival but can become harmful if prolonged.
Hepatic encephalopathy
The patient, a 47-year-old man with hepatitis B-related cirrhosis and diabetes, presented with decreased sensorium after an episode of hematemesis. On examination, he was stuporous with signs of hepatic dysfunction. Laboratory tests found elevated ammonia levels. He was diagnosed with hepatic encephalopathy secondary to upper GI bleeding from esophageal varices. Treatment included lactulose, rifaximin, IV BCAAs, and a vasopressin analogue. He improved and was later discharged on oral BCAA supplementation for outpatient management to prevent recurrent episodes. On follow-up, he showed signs of protein-calorie malnutrition.
Metabolic Response to Trauma.pptx
The document discusses the metabolic response to trauma in three phases: ebb, flow, and anabolic. The ebb phase is characterized by decreased metabolism and energy expenditure. The flow phase sees increased metabolism and catabolism as the body mobilizes resources. The anabolic phase involves tissue repair and recovery of lost mass. Key hormonal and inflammatory responses that regulate metabolism are also described, including increased catecholamines, cortisol, cytokines and the stress response they induce.
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Respon endokrin dan metabolik terhadap trauma
The document discusses the endocrine and metabolic response to trauma. It notes that trauma causes a stress response involving the hypothalamus, pituitary, and adrenal glands. This leads to two phases - an initial "ebb phase" with shock and decreased energy, followed by a "flow phase" with restored circulation and a hypermetabolic state. Strategies are described to attenuate the metabolic response during each phase through fluid replacement, oxygen, nutrition support, and preventing complications.
Metabolic response to trauma
The document discusses the metabolic response that occurs following injury or trauma to the body. It describes how there is an initial ebb phase characterized by shock, followed by a longer flow phase with increased metabolism and hormone levels. The metabolic response aims to restore homeostasis but can also cause organ damage. Factors like infection, nutrition, and inflammation can modify this response. Managing the response through fluid resuscitation, oxygen delivery, and minimizing stressors can improve outcomes.
Metabolic response to injury
Stress response caused by events such as surgical trauma includes endocrine, metabolic and immunological changes. Stress hormones and cytokines play a role in these reactions. More reactions are induced by greater stress, ultimately leading to greater catabolic effects. Cuthbertson reported the characteristic response that occurs in trauma patients: protein and fat consumption and protection of body fluids and electrolytes because of hypermetabolism in the early period. The oxygen and energy requirement increases in proportion to the severity of trauma. The awareness of alterations in amino acid, lipid, and carbohydrate metabolism changes in surgical patients is important in determining metabolic and nutritional support. The main metabolic change in response to injury that leads to a series of reactions is the reduction of the normal anabolic effect of insulin, i.e. the development of insulin resistance. Free fatty acids are primary sources of energy after trauma. Triglycerides meet 50 to 80 % of the consumed energy after trauma and in critical illness. Surgical stress and trauma result in a reduction in protein synthesis and moderate protein degradation. Severe trauma, burns and sepsis result in increased protein degradation. The aim of glucose administration to surgical patients during fasting is to reduce proteolysis and to prevent loss of muscle mass. In major stress such as sepsis and trauma, it is important both to reduce the catabolic response that is the key to faster healing after surgery and to obtain a balanced metabolism in the shortest possible time with minimum loss. For these reasons, the details of metabolic response to trauma should be known in managing these situations and patients should be treated accordingly
Metabolic response to trauma
The document discusses the metabolic response to trauma and injury. It begins by outlining the objectives of understanding the metabolic response and how it can be minimized through elective or emergency surgical procedures. It then describes the physiological changes that occur such as increases in temperature, heart rate, and metabolic rate. These changes are mediated by the neuroendocrine stress response and proinflammatory cytokines. The document outlines the ebb and flow phases of metabolic response, describing the catabolic effects in the ebb phase and hypermetabolic effects in the flow phase. Key aspects of the metabolic response include hypermetabolism, insulin resistance, protein catabolism, and changes in body composition. Methods to minimize the metabolic response include fluid resuscitation, oxygen
Relationship between trauma and diseases
The document discusses the relationship between trauma and diseases. It covers several key points:
1) Trauma can indirectly impact diseases by activating or accelerating latent conditions, especially if accompanied by infection, reduced exercise, weight gain or overeating.
2) Major injuries are associated with an inflammatory response that can lead to multiple organ failure and death if not properly treated.
3) The metabolic response to trauma involves neuroendocrine and immune system changes that mobilize energy stores and substrates. This response aims to aid recovery but can damage distant organs if severe.
4) Specific diseases that can be impacted by trauma include post-traumatic stress disorder, diabetes, rhabdomyolysis (muscle breakdown),
Homeostasis, the internal milieu of the human body
This document discusses homeostasis and the body's response to injury. It covers several key points:
1. Homeostasis refers to maintaining a constant internal environment. The body has complex coordinated physiological processes to maintain homeostasis.
2. Following major trauma or sepsis, the body exhibits a systemic inflammatory response and loses homeostasis. Medical intervention is needed to return the patient to homeostasis.
3. The response to injury is graded - more severe injuries cause a greater physiological and immunological response. This includes fever, increased metabolism and catabolism.
4. Several factors mediate the metabolic response, including neuroendocrine hormones and cytokines. The response aims to provide substrates for survival but can become harmful if prolonged.
Hepatic encephalopathy
The patient, a 47-year-old man with hepatitis B-related cirrhosis and diabetes, presented with decreased sensorium after an episode of hematemesis. On examination, he was stuporous with signs of hepatic dysfunction. Laboratory tests found elevated ammonia levels. He was diagnosed with hepatic encephalopathy secondary to upper GI bleeding from esophageal varices. Treatment included lactulose, rifaximin, IV BCAAs, and a vasopressin analogue. He improved and was later discharged on oral BCAA supplementation for outpatient management to prevent recurrent episodes. On follow-up, he showed signs of protein-calorie malnutrition.
Metabolic Response to Trauma.pptx
The document discusses the metabolic response to trauma in three phases: ebb, flow, and anabolic. The ebb phase is characterized by decreased metabolism and energy expenditure. The flow phase sees increased metabolism and catabolism as the body mobilizes resources. The anabolic phase involves tissue repair and recovery of lost mass. Key hormonal and inflammatory responses that regulate metabolism are also described, including increased catecholamines, cortisol, cytokines and the stress response they induce.
Metabolic response to injury
The document summarizes the metabolic response to trauma and injury. It describes the ebb and flow phases identified by Cuthbertson in the 1930s. The ebb phase lasts less than 24 hours and aims to conserve circulating volume and energy stores. The flow phase lasts 3-10 days and involves mobilizing stores for repair through hypermetabolism, increased protein breakdown, and insulin resistance. Nutritional, hormonal, and biologic interventions can help attenuate this catabolic response to injury and promote anabolism.
Metabolic Response to Injury
The document summarizes the metabolic response to injury, which occurs in two phases - the ebb phase and the flow phase. The ebb phase occurs in the first 24-48 hours and is characterized by decreased metabolic rate and circulation. The flow phase involves increased metabolism and mobilization of energy stores for recovery. Key aspects of the flow phase include hypermetabolism, muscle wasting through increased protein degradation, acute phase protein response in the liver, and insulin resistance in tissues. The response aims to prioritize resources towards vital organs and wound healing.
Shock.pptx
1. Shock is defined as inadequate tissue perfusion due to failure of oxygen delivery, transport, or utilization, leading to cellular dysfunction.
2. The main types of shock are hypovolemic, traumatic, septic, and cardiogenic shock.
3. Treatment of shock involves identifying and treating the underlying cause, restoring circulating volume with intravenous fluids, and providing supportive care such as oxygen supplementation. Damage control resuscitation aims to correct the "lethal triad" of coagulopathy, acidosis, and hypothermia.
Hypothalamus 15 apr 2016
The hypothalamus is located below the thalamus and forms parts of the lower walls and floor of the third ventricle. It contains several nuclei that regulate a variety of critical functions including the autonomic nervous system, anterior pituitary hormone secretion, body temperature, food/water intake, and circadian rhythms. Damage to different hypothalamic regions can lead to disorders such as obesity, emaciation, diabetes insipidus, and temperature dysregulation.
overview on "Metabolic response to injury"
The document summarizes the body's metabolic response to injury and trauma. It discusses how the response is mediated by both the neuroendocrine and immune systems through hormones and cytokines. The response aims to mobilize energy stores and nutrients to support healing, but can become maladaptive. The response proceeds in ebb and flow phases, with an initial catabolic phase followed by an anabolic recovery phase. Factors like continuing bleeding, hypothermia, edema, underperfusion, starvation, and immobility can compound the response and inhibit recovery. Maintaining homeostasis through careful fluid management, analgesia, feeding, and early mobilization can help optimize the response and enhance recovery.
Metabolicresponsetoinjury drneerajjain
This document discusses the metabolic response to trauma and injury. It describes how injury disrupts homeostasis and causes physiological, metabolic and clinical changes as the body attempts to restore homeostasis. The stress response is mediated by hormones like cortisol and cytokines which cause hypermetabolism, increased protein breakdown, and insulin resistance. These changes are initially beneficial for survival but can become harmful if prolonged. Modern trauma and critical care aims to minimize this response through techniques like early feeding and pain control to promote recovery.
metabolic_response_to_injury.ppt
The document discusses the metabolic response to injury and surgery. It involves complex neuroendocrine mechanisms across multiple body systems trying to restore homeostasis. There are two phases - an initial catabolic phase where proteins and fats are broken down, followed by an anabolic phase where stores are restored. A key response is inflammation mediated by cytokines which causes local and systemic effects. Hypovolaemia is another response where fluid is lost, triggering mechanisms like ADH and aldosterone secretion to conserve fluid and electrolytes and restore circulating volume. The overall response aims to support healing while challenging homeostasis.
Shock
Shock is a state of low tissue perfusion that impairs cellular respiration. It results from decreased blood flow caused by factors like blood loss, dehydration, heart issues, or infection. Left untreated, shock progresses through stages as the body's compensatory mechanisms fail. Types include hypovolemic, cardiogenic, obstructive, distributive, and neurogenic shock. Treatment focuses on identifying and treating the underlying cause while improving cardiac output and tissue perfusion through fluid resuscitation, oxygen supplementation, antibiotics for infection, and other interventions depending on the shock type. Monitoring includes vital signs, urine output, blood tests, and imaging to guide resuscitation goals like adequate blood pressure, urine output, and oxygen levels
Metabolic Response To Injury
The document summarizes the metabolic response to injury, including its graded nature, components, mediators, phases, and factors that exacerbate or can be avoided. The response involves physiological, metabolic, clinical, and laboratory changes mediated by neuroendocrine and immune system factors. It progresses through ebb and flow phases involving catabolic elements like hypermetabolism and muscle/liver protein alterations. Avoidable exacerbating factors include continuing hemorrhage, hypothermia, tissue edema, underperfusion, starvation, and immobility. The response can be modulated through techniques like minimal access surgery, early mobilization, epidural analgesia, and avoiding prolonged fasting and excessive fluids.
Shock (2).pptx
1. The document provides tips for using a PowerPoint presentation (ppt) for active learning sessions.
2. It recommends showing blank slides first to elicit what students already know, then showing slides with content.
3. This approach should be repeated through three revisions for an engaging learning experience beneficial for self-study.
1011shock-161227090739.pdf
This document discusses shock, including its pathophysiology, classification, clinical features, consequences, and resuscitation. Shock is defined as inadequate tissue perfusion resulting in cellular changes from aerobic to anaerobic metabolism. The main types of shock are hypovolemic, cardiogenic, obstructive, distributive, and endocrine. Left untreated, shock can lead to multiple organ failure and death. Initial resuscitation focuses on airway, breathing, and restoring circulating volume through fluid administration. Ongoing monitoring and support of vital organs is needed until the underlying cause is addressed.
10 &11 shock
Shock is a state of low tissue perfusion that prevents normal cellular respiration. There are several classifications of shock including hypovolaemic, cardiogenic, obstructive, distributive, and endocrine shock. The key goals of resuscitation are to ensure adequate oxygenation, ventilation, and cardiovascular support through fluid administration and vasopressors if needed. Ongoing monitoring of vital signs, urine output, and markers of tissue perfusion like lactate levels are important to guide resuscitation efforts and avoid complications like multiple organ failure.
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This document discusses fluid balance and fluid therapy. It begins by defining fluid balance as when water intake equals water loss each day. It then discusses total body water content and its compartments. Key points include that intravenous fluids can be classified as crystalloids or colloids. Common crystalloid fluids discussed include normal saline, Ringer's lactate, dextrose 5%, and Isolyte solutions. Albumin and dextran are presented as examples of colloid fluids. Indications, contraindications, and complications of various intravenous fluids are provided.
Metabolic response to injury
The body responds to stress and injury through metabolic and inflammatory responses known as the ebb and flow phases. In the initial ebb phase, metabolism decreases to conserve energy and resources. The subsequent flow phase involves increased metabolism and inflammation to restore function and fight infection. Prolonged or excessive response can lead to organ dysfunction or failure through effects like fluid shifts, immune imbalance, and metabolic changes that impact protein, carbohydrate and fat metabolism. Factors like severity of injury, infection, fluid status, and nutrition influence the response and clinical outcomes.
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Metabolic stress response
The document outlines the metabolic response to trauma, including its initiators, mediators, phases, and components. The metabolic response is the body's attempt to maintain homeostasis following injury. It is initiated by factors like pain, infection, and hypoxia. It is mediated by the neuroendocrine and immune systems through the release of hormones and cytokines. The response occurs in ebb and flow phases and results in hypermetabolism, protein catabolism, insulin resistance, and other physiological changes aimed at repairing damage and restoring normal function.
homeostasis-210302030230.pdf
- Homeostasis refers to the maintenance of stable internal conditions in the body despite changes in the external environment.
- The internal environment is the extracellular fluid (ECF) that surrounds cells, including plasma and interstitial fluid. Changes in the ECF directly impact cells.
- Homeostatic mechanisms, including negative feedback and feedforward mechanisms, work to sense deviations from normal ranges and activate effectors to correct imbalances and maintain homeostasis.
Homeostasis I Negative and Positive Feedback Mechanism I Feedforward Mechanis...
Homeostasis I Negative and Positive Feedback Mechanism I Feedforward Mechanism I General Physiology I
The slide will be about :
1. Definition of homeostasis
2. What is internal environment ?
3. Why ECF is considered as an internal environment for cell ?
4. Homeostatic mechanism
5. Components of homeostatic mechanism
6. Feedback mechanism
7. Negative feedback mechanism
8. Positive feedback mechanism
9. Feedforward mechanism
You can also watch the same topic on HM Learnings Youtube channel.
You can also follow HM Learnings on facebook, instagram and twitter for daily updates
metabolic response to trauma.pptx
1. The document provides tips for using a PowerPoint presentation on metabolic response to trauma. It suggests freely editing the presentation, asking students questions about blank slides, and repeating the process for active learning.
2. The metabolic response to trauma involves physiological neuroendocrine reflexes that restore homeostasis. Trauma stimulates sensors which activate the hypothalamic-pituitary-adrenal axis and sympathetic nervous system. This increases stress hormones like cortisol and catecholamines.
3. The metabolic effects include hypermetabolism, hyperglycemia, increased protein breakdown and gluconeogenesis from protein. This supports the body during injury but causes negative nitrogen balance.
Dentistry L8 METABOLIC RESPONSE TO TRAUMA-1.pptx
The metabolic response to trauma involves complex metabolic changes mediated by the neuroendocrine system to reduce the effects of injury and return the body to its preinjury state. It occurs in three phases: the ebb phase aims to conserve energy in the initial 24-48 hours after trauma; the flow phase is catabolic for about 7 days due to increased hormones that cause weight loss; and the anabolic recovery phase lasts 2-4 weeks to replace losses and restore the body's preinjury condition.
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Diagnosis and Staging
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Treatment Options
Endocrine Therapy
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Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
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Metabolic response to injury
The document summarizes the metabolic response to trauma and injury. It describes the ebb and flow phases identified by Cuthbertson in the 1930s. The ebb phase lasts less than 24 hours and aims to conserve circulating volume and energy stores. The flow phase lasts 3-10 days and involves mobilizing stores for repair through hypermetabolism, increased protein breakdown, and insulin resistance. Nutritional, hormonal, and biologic interventions can help attenuate this catabolic response to injury and promote anabolism.
Metabolic Response to Injury
The document summarizes the metabolic response to injury, which occurs in two phases - the ebb phase and the flow phase. The ebb phase occurs in the first 24-48 hours and is characterized by decreased metabolic rate and circulation. The flow phase involves increased metabolism and mobilization of energy stores for recovery. Key aspects of the flow phase include hypermetabolism, muscle wasting through increased protein degradation, acute phase protein response in the liver, and insulin resistance in tissues. The response aims to prioritize resources towards vital organs and wound healing.
Shock.pptx
1. Shock is defined as inadequate tissue perfusion due to failure of oxygen delivery, transport, or utilization, leading to cellular dysfunction.
2. The main types of shock are hypovolemic, traumatic, septic, and cardiogenic shock.
3. Treatment of shock involves identifying and treating the underlying cause, restoring circulating volume with intravenous fluids, and providing supportive care such as oxygen supplementation. Damage control resuscitation aims to correct the "lethal triad" of coagulopathy, acidosis, and hypothermia.
Hypothalamus 15 apr 2016
The hypothalamus is located below the thalamus and forms parts of the lower walls and floor of the third ventricle. It contains several nuclei that regulate a variety of critical functions including the autonomic nervous system, anterior pituitary hormone secretion, body temperature, food/water intake, and circadian rhythms. Damage to different hypothalamic regions can lead to disorders such as obesity, emaciation, diabetes insipidus, and temperature dysregulation.
overview on "Metabolic response to injury"
The document summarizes the body's metabolic response to injury and trauma. It discusses how the response is mediated by both the neuroendocrine and immune systems through hormones and cytokines. The response aims to mobilize energy stores and nutrients to support healing, but can become maladaptive. The response proceeds in ebb and flow phases, with an initial catabolic phase followed by an anabolic recovery phase. Factors like continuing bleeding, hypothermia, edema, underperfusion, starvation, and immobility can compound the response and inhibit recovery. Maintaining homeostasis through careful fluid management, analgesia, feeding, and early mobilization can help optimize the response and enhance recovery.
Metabolicresponsetoinjury drneerajjain
This document discusses the metabolic response to trauma and injury. It describes how injury disrupts homeostasis and causes physiological, metabolic and clinical changes as the body attempts to restore homeostasis. The stress response is mediated by hormones like cortisol and cytokines which cause hypermetabolism, increased protein breakdown, and insulin resistance. These changes are initially beneficial for survival but can become harmful if prolonged. Modern trauma and critical care aims to minimize this response through techniques like early feeding and pain control to promote recovery.
metabolic_response_to_injury.ppt
The document discusses the metabolic response to injury and surgery. It involves complex neuroendocrine mechanisms across multiple body systems trying to restore homeostasis. There are two phases - an initial catabolic phase where proteins and fats are broken down, followed by an anabolic phase where stores are restored. A key response is inflammation mediated by cytokines which causes local and systemic effects. Hypovolaemia is another response where fluid is lost, triggering mechanisms like ADH and aldosterone secretion to conserve fluid and electrolytes and restore circulating volume. The overall response aims to support healing while challenging homeostasis.
Shock
Shock is a state of low tissue perfusion that impairs cellular respiration. It results from decreased blood flow caused by factors like blood loss, dehydration, heart issues, or infection. Left untreated, shock progresses through stages as the body's compensatory mechanisms fail. Types include hypovolemic, cardiogenic, obstructive, distributive, and neurogenic shock. Treatment focuses on identifying and treating the underlying cause while improving cardiac output and tissue perfusion through fluid resuscitation, oxygen supplementation, antibiotics for infection, and other interventions depending on the shock type. Monitoring includes vital signs, urine output, blood tests, and imaging to guide resuscitation goals like adequate blood pressure, urine output, and oxygen levels
Metabolic Response To Injury
The document summarizes the metabolic response to injury, including its graded nature, components, mediators, phases, and factors that exacerbate or can be avoided. The response involves physiological, metabolic, clinical, and laboratory changes mediated by neuroendocrine and immune system factors. It progresses through ebb and flow phases involving catabolic elements like hypermetabolism and muscle/liver protein alterations. Avoidable exacerbating factors include continuing hemorrhage, hypothermia, tissue edema, underperfusion, starvation, and immobility. The response can be modulated through techniques like minimal access surgery, early mobilization, epidural analgesia, and avoiding prolonged fasting and excessive fluids.
Shock (2).pptx
1. The document provides tips for using a PowerPoint presentation (ppt) for active learning sessions.
2. It recommends showing blank slides first to elicit what students already know, then showing slides with content.
3. This approach should be repeated through three revisions for an engaging learning experience beneficial for self-study.
1011shock-161227090739.pdf
This document discusses shock, including its pathophysiology, classification, clinical features, consequences, and resuscitation. Shock is defined as inadequate tissue perfusion resulting in cellular changes from aerobic to anaerobic metabolism. The main types of shock are hypovolemic, cardiogenic, obstructive, distributive, and endocrine. Left untreated, shock can lead to multiple organ failure and death. Initial resuscitation focuses on airway, breathing, and restoring circulating volume through fluid administration. Ongoing monitoring and support of vital organs is needed until the underlying cause is addressed.
10 &11 shock
Shock is a state of low tissue perfusion that prevents normal cellular respiration. There are several classifications of shock including hypovolaemic, cardiogenic, obstructive, distributive, and endocrine shock. The key goals of resuscitation are to ensure adequate oxygenation, ventilation, and cardiovascular support through fluid administration and vasopressors if needed. Ongoing monitoring of vital signs, urine output, and markers of tissue perfusion like lactate levels are important to guide resuscitation efforts and avoid complications like multiple organ failure.
Fluid & Electrolyte balance by Dr Nesar
This document discusses fluid balance and fluid therapy. It begins by defining fluid balance as when water intake equals water loss each day. It then discusses total body water content and its compartments. Key points include that intravenous fluids can be classified as crystalloids or colloids. Common crystalloid fluids discussed include normal saline, Ringer's lactate, dextrose 5%, and Isolyte solutions. Albumin and dextran are presented as examples of colloid fluids. Indications, contraindications, and complications of various intravenous fluids are provided.
Metabolic response to injury
The body responds to stress and injury through metabolic and inflammatory responses known as the ebb and flow phases. In the initial ebb phase, metabolism decreases to conserve energy and resources. The subsequent flow phase involves increased metabolism and inflammation to restore function and fight infection. Prolonged or excessive response can lead to organ dysfunction or failure through effects like fluid shifts, immune imbalance, and metabolic changes that impact protein, carbohydrate and fat metabolism. Factors like severity of injury, infection, fluid status, and nutrition influence the response and clinical outcomes.
CVS-_Therapy_of_Shock.pdf
Pharmacology Lecture Slides on Therapy of Shock by Sanjaya Mani Dixit Assistant Professor of Pharmacology at Kathmandu Medical College
Metabolic stress response
The document outlines the metabolic response to trauma, including its initiators, mediators, phases, and components. The metabolic response is the body's attempt to maintain homeostasis following injury. It is initiated by factors like pain, infection, and hypoxia. It is mediated by the neuroendocrine and immune systems through the release of hormones and cytokines. The response occurs in ebb and flow phases and results in hypermetabolism, protein catabolism, insulin resistance, and other physiological changes aimed at repairing damage and restoring normal function.
homeostasis-210302030230.pdf
- Homeostasis refers to the maintenance of stable internal conditions in the body despite changes in the external environment.
- The internal environment is the extracellular fluid (ECF) that surrounds cells, including plasma and interstitial fluid. Changes in the ECF directly impact cells.
- Homeostatic mechanisms, including negative feedback and feedforward mechanisms, work to sense deviations from normal ranges and activate effectors to correct imbalances and maintain homeostasis.
Homeostasis I Negative and Positive Feedback Mechanism I Feedforward Mechanis...
Homeostasis I Negative and Positive Feedback Mechanism I Feedforward Mechanism I General Physiology I
The slide will be about :
1. Definition of homeostasis
2. What is internal environment ?
3. Why ECF is considered as an internal environment for cell ?
4. Homeostatic mechanism
5. Components of homeostatic mechanism
6. Feedback mechanism
7. Negative feedback mechanism
8. Positive feedback mechanism
9. Feedforward mechanism
You can also watch the same topic on HM Learnings Youtube channel.
You can also follow HM Learnings on facebook, instagram and twitter for daily updates
metabolic response to trauma.pptx
1. The document provides tips for using a PowerPoint presentation on metabolic response to trauma. It suggests freely editing the presentation, asking students questions about blank slides, and repeating the process for active learning.
2. The metabolic response to trauma involves physiological neuroendocrine reflexes that restore homeostasis. Trauma stimulates sensors which activate the hypothalamic-pituitary-adrenal axis and sympathetic nervous system. This increases stress hormones like cortisol and catecholamines.
3. The metabolic effects include hypermetabolism, hyperglycemia, increased protein breakdown and gluconeogenesis from protein. This supports the body during injury but causes negative nitrogen balance.
Dentistry L8 METABOLIC RESPONSE TO TRAUMA-1.pptx
The metabolic response to trauma involves complex metabolic changes mediated by the neuroendocrine system to reduce the effects of injury and return the body to its preinjury state. It occurs in three phases: the ebb phase aims to conserve energy in the initial 24-48 hours after trauma; the flow phase is catabolic for about 7 days due to increased hormones that cause weight loss; and the anabolic recovery phase lasts 2-4 weeks to replace losses and restore the body's preinjury condition.
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Homeostasis I Negative and Positive Feedback Mechanism I Feedforward Mechanis...
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Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
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- 8. Metabolic response Ebb Phase : Occurs within minutes after trauma • Hypovolemic shock, hypoxia, decrease of energy expenditure Flow Phase : Occurs hours after trauma • Tissue perfusion is restored, volume deficit is controlled, hypermetabolic status, hyperglycemia, hyperthermia. • Has two sub phase : catabolic and anabolic sub phase
- 9. Ebb phase and Flow phase
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Editor's Notes
- Stres/trauma didefinisikan sebagai keadaan homeostatis yang terancam akibat paparan terhadap kekuatan yang merugikan (stresor) seperti trauma, infeksi, luka bakar, dan pembedahan. Respon terhadap trauma mencakup berbagai perubahan endokrin dan metabolik. Tingkat keparahan perubahan ini berhubungan dengan jumlah stres yang terpapar. Hal ini nberlaku pada anak dengan luas permukaannya lebih sedikit/kecil. Sehingga perbandingan stressnya lebih besar
- Fase Ebb : Terjadi dalam beberapa menit setelah trauma Syok hipovolemik, hipoksia, penurunan pengeluaran energi Fase Aliran : Terjadi beberapa jam setelah trauma Perfusi jaringan dipulihkan, defisit volume terkontrol, status hipermetabolik, hiperglikemia, hipertermia. Memiliki dua sub fase: sub fase katabolik dan anabolic Katabolisme adalah metabolisme degradatif yang melibatkan pelepasan energi dan mengakibatkan pemecahan bahan kompleks (seperti protein atau lipid) di dalam organisme. Anabolim adalah bagian konstruktif metabolisme yang berkaitan terutama dengan sintesis makromolekul Katabolisme adalah penguraian molekul-molekul kompleks menjadi molekul-molekul yang lebih kecil untuk mendapatkan energi. Katabolisme terjadi pada proses pencernaan makanan. Nasi yang kita makan merupakan karbohidrat, saat masuk kedalam pencernaan karbohidrat nasi dipecah menjadi glukosa dan energi dengan bantuan enzim amilase Kebalikan dari katabolisme, anabolisme adalah proses pembentukan senyawa kompleks (makromolekul) yang dibutuhkan oleh sel dari molekul sederhana dengan bantuan energi. Makromolekul hasil anabolisme digunakan untuk pertumbuhan tubuh makhluk hidup . Contoh dari anabolisme adalah sintesis protein, sintesis DNA, fotosintesis. Sintesis Protein Sintesis atau pembuatan protein berlangsung didalam ribosom. Protein dibuat dari mikromolekul asam amino yang diperoleh dari hasil katabolisme. Protein berfungsi sebagai enzim dan juga struktur pembangun tubuh makhluk hidup
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