Haemodynamics: interpreting shock profiles: practice question

A Pathology 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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Pathology · Haemodynamics: interpreting shock profiles

Sample item

After a road accident a 30-year-old man has cold clammy skin and a heart rate of 130 per minute. Pulmonary artery catheter readings show a cardiac output of 2.1 L/min/m2 (low), central venous pressure 2 mmHg (low), pulmonary capillary wedge pressure 4 mmHg (low) and systemic vascular resistance high. Which type of shock is this?

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

The answer and the reasoning

A. Hypovolaemic shock

Low filling pressures (central venous and wedge pressure) with low output and compensatory vasoconstriction mean there is not enough circulating volume. This is hypovolaemic shock from haemorrhage. Cardiogenic shock shows high wedge pressure, neurogenic shock shows low resistance, and tamponade shows raised, equalised right and left filling pressures.

Option by option

  • A. Hypovolaemic shock (correct)

    Correct. Low preload with a high systemic vascular resistance is the haemorrhagic pattern.

  • B. Neurogenic shock

    Neurogenic shock is a distributive state with low systemic vascular resistance and warm, dry skin.

  • C. Obstructive shock due to cardiac tamponade

    Tamponade raises central venous and wedge pressures and equalises them, which is not seen here.

  • D. Cardiogenic shock

    Cardiogenic shock has low output but a high wedge pressure from the failing pump.

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 Pathology question

What is the answer to this Pathology question?

The best answer is A, Hypovolaemic shock. Low filling pressures (central venous and wedge pressure) with low output and compensatory vasoconstriction mean there is not enough circulating volume.

Why is "Neurogenic shock" not the answer?

Neurogenic shock is a distributive state with low systemic vascular resistance and warm, dry skin.

Why is "Obstructive shock due to cardiac tamponade" not the answer?

Tamponade raises central venous and wedge pressures and equalises them, which is not seen here.

Why is "Cardiogenic shock" not the answer?

Cardiogenic shock has low output but a high wedge pressure from the failing pump.

What concept does this question test?

It tests Haemodynamics: interpreting shock profiles in Pathology. This is hypovolaemic shock from haemorrhage. Cardiogenic shock shows high wedge pressure, neurogenic shock shows low resistance, and tamponade shows raised, equalised right and left filling pressures.

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 Haemodynamics: interpreting shock profiles?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.