Critical care: adding vasopressin in septic shock: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Critical care: adding vasopressin in septic shock

Sample item

A patient in septic shock remains hypotensive on norepinephrine at 0.3 mcg/kg/min after adequate fluids. Which is the recommended next step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Add vasopressin to the norepinephrine

Guidelines suggest adding vasopressin (fixed dose of about 0.03 units/min) when norepinephrine requirements rise, rather than escalating norepinephrine alone. This spares catecholamine dose and may reduce arrhythmias. Epinephrine can be added if perfusion remains inadequate.

Option by option

  • A. Start a nitroprusside infusion

    Nitroprusside is a vasodilator and would worsen hypotension.

  • B. Stop norepinephrine and start dopamine alone

    Dopamine is not preferred and causes more arrhythmias.

  • C. Add vasopressin to the norepinephrine (correct)

    Correct. Vasopressin is the recommended second vasopressor.

  • D. Give a further 2 litres of colloid without reassessment

    Fluids should be given only if the patient remains fluid responsive.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is C, Add vasopressin to the norepinephrine. Guidelines suggest adding vasopressin (fixed dose of about 0.

Why is "Start a nitroprusside infusion" not the answer?

Nitroprusside is a vasodilator and would worsen hypotension.

Why is "Stop norepinephrine and start dopamine alone" not the answer?

Dopamine is not preferred and causes more arrhythmias.

Why is "Give a further 2 litres of colloid without reassessment" not the answer?

Fluids should be given only if the patient remains fluid responsive.

What concept does this question test?

It tests Critical care: adding vasopressin in septic shock in Anaesthesia. 03 units/min) when norepinephrine requirements rise, rather than escalating norepinephrine alone. This spares catecholamine dose and may reduce arrhythmias. Epinephrine can be added if perfusion remains inadequate.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Critical care: adding vasopressin in septic shock?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.