بسم الله الرحمن الرحيم Shock & DIC By Dr. Ghada Ahmed Lecturer of pathology Benha Faculty of Medicine

Shock Generalized hypoperfusion due to Inadequate Effective circulating blood volume

Pathophysiology Hypoperfusion COP Effective circ blood volume

Types of shock Hypovolemic shock Cardiogenic shock Septic shock Others (Neurogenic shock, Anaphylactic shock)

Hypovolemic Shock Venous return Cardiac out putBlood flow O2 supply (Anoxia)

Cardiogenic shock MI Arrhythmias Coronary occlusion Outflow obstruction Failure of cardiac pump COP

Septic shock ( BP) Systemic VD Cardiac contractility Endothelial injury & activation Coagulation system ++ & DIC Endotoxin

STAGES OF SHOCK Initial non-progressive Progressive Irreversible

Morphology Effect on: Kidney Adrenal GIT Lung Brain

Clinical course In hypovolemic shock In septic shock

Disseminated Intravascular Coagulopathy

DIC Thrombo-hemorrhagic disorder chch by depletion of the elements required for hemostasis

Pathogenesis (A) Widespread endothelial damage Release of thrombogenic substance Obst complic Neoplasm Severe burn/ trauma Infection

Pathogenesis (B) ++coagulation PW Thrombi in microcirc Consumption of platelets & coag factors ++ fibrinolysis

Effects of DIC Widespread fibrin deposition in microcirc. Ischemia & hemolysis Depletion of platelets & coag factors Bleeding diathesis Microinfarctions Multiple organ failure

Morphology No organ is spared: Kidney Brain Heart Pituitary