AMLS Shock and Hemodynamic Instability 2

Question 1

What is the target mean arterial pressure (MAP) in septic shock management per Surviving Sepsis guidelines?

Accepted Answer

65 mmHg or greater

Answer

The Surviving Sepsis Campaign recommends maintaining a MAP of 65 mmHg or greater in septic shock to ensure organ perfusion.

Question 2

Which class of hemorrhagic shock (using ATLS classification) first shows altered mental status?

Accepted Answer

Class III (30–40% blood loss)

Answer

Class III hemorrhage (30–40% blood volume loss) is the first class associated with altered mental status, anxiety, and confusion.

Question 3

A septic patient with a lactate of 4.2 mmol/L and hypotension despite 30 mL/kg IV fluids should receive which additional intervention?

Accepted Answer

Initiate vasopressors (norepinephrine)

Answer

Persistent hypotension after adequate fluid resuscitation in septic shock requires vasopressors, with norepinephrine as first-line.

Question 4

Pulsus paradoxus greater than 10 mmHg is a classic finding in which condition?

Accepted Answer

Cardiac tamponade

Answer

Pulsus paradoxus >10 mmHg, an exaggerated fall in BP during inspiration, is a classic sign of cardiac tamponade.

Question 5

Which finding is most suggestive of obstructive shock due to massive pulmonary embolism?

Accepted Answer

Right heart strain on ECG with hypoxia and tachycardia

Answer

Massive PE causes obstructive shock with right heart strain, manifested by S1Q3T3 pattern, tachycardia, and hypoxia.

AMLS - Advanced Medical Life Support Practice Test