FP-C Shock Management and Resuscitation 1 — Questions and Answers
Question 1: A patient presents with Beck's triad (hypotension, muffled heart sounds, jugular venous distension). Which type of shock does this suggest?
- Obstructive shock from cardiac tamponade (Correct answer)
- Cardiogenic shock from MI
- Distributive shock from sepsis
- Hypovolemic shock
Correct answer: Obstructive shock from cardiac tamponade
Beck's triad is pathognomonic for cardiac tamponade, which causes obstructive shock by preventing adequate ventricular filling.
Question 2: Which hemodynamic profile is characteristic of distributive (septic) shock?
- High CO, low SVR, low MAP (Correct answer)
- Low CO, high SVR, low MAP
- Low CO, low SVR, low MAP
- High CO, high SVR, high MAP
Correct answer: High CO, low SVR, low MAP
Septic shock is characterized by high cardiac output from tachycardia, low systemic vascular resistance from vasodilation, and resultant low MAP.
Question 3: A trauma patient with suspected hemorrhagic shock is unresponsive to 2L of crystalloid. What resuscitation strategy is preferred in modern flight medicine?
- 1:1:1 ratio of packed red cells, fresh frozen plasma, and platelets (Correct answer)
- Continue crystalloid at 500 mL boluses
- Colloid infusion with albumin
- Vasopressor initiation with norepinephrine
Correct answer: 1:1:1 ratio of packed red cells, fresh frozen plasma, and platelets
Damage control resuscitation using a 1:1:1 ratio of pRBC:FFP:platelets is the evidence-based approach for hemorrhagic shock to restore coagulation factors alongside volume.
Question 4: In neurogenic shock following spinal cord injury, which hemodynamic combination is expected?
- Hypotension with bradycardia (Correct answer)
- Hypotension with tachycardia
- Hypertension with bradycardia
- Hypertension with tachycardia
Correct answer: Hypotension with bradycardia
Neurogenic shock presents with hypotension and paradoxical bradycardia due to loss of sympathetic tone below the injury level with intact vagal activity.
Question 5: When treating refractory septic shock with vasopressors, which agent is the FIRST-LINE choice per Surviving Sepsis guidelines?
- Norepinephrine (Correct answer)
- Epinephrine
- Vasopressin
- Dopamine
Correct answer: Norepinephrine
Norepinephrine is the first-line vasopressor for septic shock, providing potent alpha-mediated vasoconstriction with moderate beta-1 effects to raise MAP.
Question 6: A patient in hypovolemic shock has a systolic BP of 70 mmHg and is not responding to initial fluid resuscitation. What permissive hypotension target is acceptable in penetrating trauma without TBI?
- Systolic BP 80-90 mmHg (Correct answer)
- Systolic BP 100-110 mmHg
- MAP 65-70 mmHg
- Systolic BP 60-70 mmHg
Correct answer: Systolic BP 80-90 mmHg
Permissive hypotension targeting a systolic BP of 80-90 mmHg reduces ongoing hemorrhage and dilutional coagulopathy in penetrating trauma without TBI.
FP-C Shock Management and Resuscitation 1
A patient presents with Beck's triad (hypotension, muffled heart sounds, jugular venous distension).
Which type of shock does this suggest?