Preparatory Mindset

Shock is about MICROCIRCULATION, not just blood pressure. A patient can have normal BP but already be in early compensated shock. The real problem is tissue hypoxia. Stages are a progression: early (reversible), late (organs at risk), irreversible (DIC, MODS). DIC is both a cause AND consequence of shock — a vicious cycle.

Core Concepts

• Shock = acute circulatory failure → inadequate tissue perfusion → cellular hypoxia.


• Three types: (1) Hypovolemic: loss of blood/fluid (hemorrhage, burns, dehydration); (2) Cardiogenic: pump failure (MI, severe HF); (3) Vasogenic/distributive: vasodilation (sepsis → septic shock, anaphylaxis, neurogenic).


• Stages: Compensated (tachycardia, vasoconstriction, normal BP), Decompensated (hypotension, organ dysfunction), Irreversible (refractory hypotension, MODS).


• DIC: pathological activation of coagulation → microthrombi consume clotting factors → simultaneous thrombosis AND bleeding..

High-Yield Points

• Three types: hypovolemic (↓ volume), cardiogenic (↓ pump), vasogenic (↓ resistance)


• Stages: compensated (normal BP), decompensated (↓ BP, organ dysfunction), irreversible


• DIC: simultaneous thrombosis and bleeding — microthrombi consume clotting factors


• Treatment: fluids (hypovolemic), inotropes (cardiogenic), vasopressors + treat cause (vasogenic)

Topic Summary

Shock is acute circulatory failure → tissue hypoperfusion → cellular hypoxia. Three main types: hypovolemic, cardiogenic, vasogenic. DIC is a complication of prolonged shock involving simultaneous thrombosis and bleeding. Treatment: correct the cause and support circulation.