AMLS Shock and Hemodynamic Instability 3

Question 1

What is the pathophysiologic mechanism underlying cardiogenic shock?

Accepted Answer

Pump failure reduces cardiac output causing tissue hypoperfusion

Answer

Massive vasodilation lowers systemic vascular resistance

Answer

Obstruction impairs ventricular filling

Answer

Volume depletion reduces preload

Question 2

Which clinical finding indicates a positive response to a fluid challenge in a hypotensive patient?

Accepted Answer

Increase in pulse pressure and improvement in mental status

Answer

Decrease in heart rate only

Answer

Normalization of respiratory rate alone

Answer

Rise in temperature

Question 3

A patient in decompensated shock has cold, mottled extremities and a capillary refill of 5 seconds. What organ is most immediately at risk?

Accepted Answer

Kidneys (acute tubular necrosis)

Answer

Skin (pressure ulcers)

Answer

Liver (fatty change)

Answer

Brain (dementia)

Question 4

What is the significance of a serum lactate greater than 4 mmol/L in a shock patient?

Accepted Answer

Indicates severe tissue hypoperfusion and high mortality risk

Answer

Is a normal finding in exercise-induced stress

Answer

Confirms diabetic ketoacidosis

Answer

Indicates respiratory alkalosis

Question 5

Which intervention is definitive for obstructive shock caused by tension pneumothorax?

Accepted Answer

Needle decompression followed by chest tube thoracostomy

Answer

Pericardiocentesis

Answer

Immediate intubation

Answer

IV fluid resuscitation

Question 6

Which parameter is most useful for determining if a patient will respond to fluid resuscitation?

Accepted Answer

Passive leg raise test with cardiac output monitoring

Answer

Central venous pressure alone

Answer

Blood pressure alone

Answer

Heart rate alone