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

4. Shock Generalized hypoperfusion due to Inadequate Effective circulating blood volume

5. Pathophysiology Hypoperfusion COP Effective circ blood volume

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

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

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

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

10. STAGES OF SHOCK Initial non-progressive Progressive Irreversible

12. Morphology Effect on: Kidney Adrenal GIT Lung Brain

13. Clinical course In hypovolemic shock In septic shock

14. Disseminated Intravascular Coagulopathy

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

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

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

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

19. Morphology No organ is spared: Kidney Brain Heart Pituitary