Diagnosis of Shock

What Causes Shock?

Basic Science and Pathophysiology

2 Topics

What Determines Oxygen Delivery?

Inadequate Delivery

Clinical Assessment and Risk Stratification

7 Topics

Respiratory Rate

Conscious Level and Urine Output

Central Venous Oxygen Saturation

Early Goal-directed Approach

3 Topics

Diagnosis of Shock – Post Test

Diagnosis of Shock – Post Test

Diagnosis of Shock Diagnosis of Shock – Post Test

Time limit: 0

Exam Summary

0 of 10 Questions completed

Questions:

Information

You have already completed the exam before. Hence you can not start it again.

Exam is loading…

You must sign in or sign up to start the exam.

You must first complete the following:

Results

Exam complete. Results are being recorded.

Results

Time has elapsed

Categories

Not categorized 0%

You will need to meet or exceed the 80% pass mark to obtain a certificate. Save the module to log it in your CPD Diary.

Enter your course reflection:

Enter your course outcomes:

1
2
3
4
5
6
7
8
9
10

Current
Review
Answered
Correct
Incorrect

Question 1 of 10

1. Question
Which of the following patients is most likely to be suffering from a type of distributive shock?
- A 32-year-old diabetic unwell following 2 days of diarrhoea and vomiting. HR 125, BP 90/54, RR 32
- An 18-year-old motorcyclist following a collision with a car. Unable to move arms and legs, evident priapism. HR 75, BP 90/54, RR 32
- A 62-year-old with metastatic cancer. Increasing shortness of breath for 2 weeks. Large globular heart on chest x-ray. HR 140, BP 90/54, RR 32
- A 48-year-old alcoholic. Admitted with 2-day history of frequent loose black tarry stools. HR 130, BP 90/54, RR 32
- A 78-year-old with ischaemic heart disease. Collapsed at bingo. Pale, cool and clammy. HR 35, BP 90/54, RR 32
Question 2 of 10

2. Question
From the five shocked patients below, which is most likely to be due to a type of obstructive shock?
- A 32-year-old man who has been trapped by the thighs between two cars
- A 26-year-old woman with pyrexia and a generalised erythaematous rash
- A 45-year-old woman with abdominal pain, diarrhoea and wheeze
- A 68-year-old man, clammy, grey, short of breath, aching central chest pain
- A 34-year-old woman, 38/40 pregnant, collapsed and pale
Question 3 of 10

3. Question
A 46-year-old man undergoing chemotherapy for acute myeloid leukaemia has suspected neutropenic sepsis.

His heart rate is 120/min, BP 95/50, his oxygen saturation is 91% on 4 l of oxygen, his haemoglobin is 6.8 g/dl, temperature 40.1oC.

Which of the following interventions will increase oxygen delivery to the tissues the most within the next 2 hours?
- Transfusing to an Hb of 9g/dl
- Titrating noradrenaline to a MAP of 65mmHg
- Reducing temp to <38oC with antipyretics
- Increasing oxygen saturation to >98%
- Commencing broad spectrum intravenous antibiotics
Question 4 of 10

4. Question
Which of the following statements regarding haemorrhagic shock in otherwise healthy adults is true?
- Blood pressure starts to fall after the loss of about 5-10% of circulating volume
- Conscious level will drop after the loss of about 20% circulating volume
- Pulse pressure will not decrease until loss of about 40% of circulating volume
- Systolic blood pressure usually increases until about 30% of circulating volume is lost
- Pulse pressure will decrease before systolic blood pressure
Question 5 of 10

5. Question
Which of the following pedestrians, hit by a car, is likely to be the most shocked?

All patients are on non-rebreathing mask at 15L/minutes O2.
- A 68-year-old male. BP 110/55, HR 65, CRT 5s, pO2 18kPa, pCO2 5.4kPA, pH 7.42
- An 8-year-old boy. BP 90/60, HR 130, CRT 3s, sats 97%
- A 26-year-old man. BP 120/60, HR 98, pO2 9.9kPa, pCO2 3.1kPa pH 7.34
- A 40-year-old woman. BP 110/ 60, HR 110, pO2 50kPa pCO2 3.3kPa, pH 7.47
- An 18-year-old man. BP 95/55, HR 120, pO2 36kPa, pCO2 4.0kPa, pH 7.37
Question 6 of 10

6. Question
A 34-year-old man sustains multiple injuries in a road traffic accident. On arrival at the emergency department (ED) he is tachycardic and hypotensive. A blood gas shows a lactate of 8.

Which of the following statements concerning the blood lactate is most accurate?
- The high blood lactate on arrival is a reliable marker of poor prognosis in this situation
- Serial measures of lactate can help guide resuscitation
- Worsening of the blood lactate in the first hour post arrival strongly suggests a poor outcome
- Blood lactate levels are irrelevant in trauma
- The elevated lactate suggests another pathology in addition to hypovolaemic shock
Question 7 of 10

7. Question
A 32-year-old woman presents with pyrexia and right loin pain. She is tachycardic and hypotensive. She responds poorly to initial fluid resuscitation and a central line is inserted. A junior asks if you are going to measure the central venous oxygen saturation.

What is the significance of central venous oxygen saturation in this situation?
- A normal or high CvO2 following resuscitation ensures good tissue perfusion
- A normal or high CvO2 is most likely to indicate inadequate oxygen delivery
- A low CvO2 suggests oxygen delivery is inadequate
- A low CvO2 necessitates higher supplemental oxygen delivery
- A low CvO2 necessitates urgent transfusion
Question 8 of 10

8. Question
Which of the following treatments is most appropriate for the patients listed below?
- One litre warmed Hartmann’s solution bolus in a 24-year-old male with single stab wound to the chest HR 120, BP 85/60, ongoing blood loss
- Hydrocortisone, 100 micrograms, in a previously well 36-year-old woman with presumed chest sepsis requiring noradrenaline infusion to maintain BP
- Two units of blood in a 43-year-old woman with bilateral femoral fractures from road traffic accident. Following crystalloid resuscitation: BP 130/70, pulse 70, Hb 8.0g/dl
- Intubation and ventilation of a 20kg boy with meningococcal sepsis after 1.2 l of fluid resuscitation. BP 100/60, HR 140, RR 60, SaO2 90%
- Crystalloid, 1L, over 2 hours in a 32-year-old diabetic with ketoacidosis. HR 130, BP 80/50
Question 9 of 10

9. Question
In which of the following patients is the instigation of inotropic support indicated?
- A 26-year-old thrown from horse. T4 sensory level and paraplegia. BP 75/40, HR 120
- A 36-year-old with a stab wound to the chest. BP 60/40, HR 140
- A 73-year-old with an inferior myocardial infarction. BP 90/60, HR 80
- A 36-year-old with sudden onset urticaria and abdominal pain. BP 70/40, HR 120
- A 68-year-old with a pulsatile abdominal mass and back pain. BP 80/50, HR 130
Question 10 of 10

10. Question
Which of the following statements regarding mortality in shock is correct?
- Severe sepsis has a mortality of about 60%
- Cardiogenic shock has a mortality of about 30%
- Worldwide, about 2 million children under 5 years die each year from hypovolaemic shock secondary to diarrhoea
- About 250 children under 5 years die each year in the UK as a result of diarrhoeal illness
- About 200 people die of anaphylactic shock in the UK each year

7 Comments

Collapse Comments

Dr Syed Shahbaz Ahmer August 2, 2023 at 1:41 pm

Great Learning

Log in to Reply

Dr Zahid Mehmood March 14, 2025 at 6:14 pm

Very informative

Log in to Reply

Dr Uche Maduabuchi Dennis Iheukor March 26, 2025 at 5:07 pm

Concise and to the point.

Log in to Reply

Dr Harika Reddy Maddireddy April 5, 2025 at 1:26 pm

very informative

Log in to Reply

Dr Nandana Wasala Kahandage April 8, 2025 at 3:24 pm

Excellent learning session.

Log in to Reply

Dr Muhammad Hayat Tabussem May 19, 2025 at 1:31 pm

Excellent presentation for the Shock and its different types along with initial assessment and mangemebt

Log in to Reply

Dr Efetobor Ibukun-oluwa Jaja May 23, 2025 at 10:56 pm

Excellent presentation with clear points

Log in to Reply

Leave a Comment Cancel reply

You must be logged in to post a comment.

We use cookies to store information to make your visit to this site richer and to personalize information according to your interests. See our privacy policy for more information on what cookies are, how we use them and how to change your preferences.

By continuing to use this site you are consenting to our use of cookies.Accept Privacy Policy Reject

Privacy Policy

Privacy Overview

This website uses cookies to improve your experience while you navigate through the website. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are as essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may have an effect on your browsing experience.

Necessary

Always Enabled

Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.

SAVE & ACCEPT