Trauma and burns: shock in children: practice question

A General Surgery 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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General Surgery · Trauma and burns: shock in children

Sample item

A 6-year-old child after a road accident has a heart rate of 150/min, cold peripheries and a capillary refill of 4 seconds, but a normal blood pressure. What does the normal blood pressure indicate?

ACompensated shock, with hypotension appearing lateBThat shock is excludedCNeurogenic shock from a spinal injuryDCardiogenic shock from myocardial contusion

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

The answer and the reasoning

A. Compensated shock, with hypotension appearing late

Children maintain blood pressure by intense vasoconstriction and tachycardia until about a quarter to a third of blood volume is lost, so hypotension is a late and ominous sign. Tachycardia, cool peripheries and prolonged capillary refill identify compensated shock, and fluid resuscitation should begin at once.

Option by option

A. Compensated shock, with hypotension appearing late (correct)
Correct. Hypotension appears late in children, so normal pressure with tachycardia and poor perfusion is compensated shock.
B. That shock is excluded
Normal pressure does not exclude shock in a child, and delaying treatment is dangerous.
C. Neurogenic shock from a spinal injury
Neurogenic shock gives hypotension with bradycardia and warm peripheries.
D. Cardiogenic shock from myocardial contusion
Cardiogenic shock from contusion is rare and would not explain this picture after trauma.

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.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Compensated shock, with hypotension appearing late. Children maintain blood pressure by intense vasoconstriction and tachycardia until about a quarter to a third of blood volume is lost, so hypotension is a late and ominous sign.

Why is "That shock is excluded" not the answer?

Normal pressure does not exclude shock in a child, and delaying treatment is dangerous.

Why is "Neurogenic shock from a spinal injury" not the answer?

Neurogenic shock gives hypotension with bradycardia and warm peripheries.

Why is "Cardiogenic shock from myocardial contusion" not the answer?

Cardiogenic shock from contusion is rare and would not explain this picture after trauma.

What concept does this question test?

It tests Trauma and burns: shock in children in General Surgery. Tachycardia, cool peripheries and prolonged capillary refill identify compensated shock, and fluid resuscitation should begin at once.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Trauma and burns: shock in children?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.