Cardiovascular system: haemodynamic profile of cardiogenic shock: practice question

A Physiology 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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Physiology · Cardiovascular system: haemodynamic profile of cardiogenic shock

Sample item

A 62-year-old man with an extensive anterior myocardial infarction is cold, clammy and breathless with blood pressure 78/50 mmHg and bibasal crepitations. Which haemodynamic pattern is expected?

ALow cardiac output, raised wedge pressure, raised systemic vascular resistanceBLow cardiac output, low wedge pressure, raised systemic vascular resistanceCHigh cardiac output, low wedge pressure, low systemic vascular resistanceDHigh cardiac output, raised wedge pressure, normal systemic vascular resistance

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

The answer and the reasoning

A. Low cardiac output, raised wedge pressure, raised systemic vascular resistance

Failure of the left ventricle reduces output and causes blood to back up into the pulmonary circulation, so the wedge pressure rises. The fall in output triggers intense sympathetic vasoconstriction, so resistance is high and the skin is cold.

Option by option

A. Low cardiac output, raised wedge pressure, raised systemic vascular resistance (correct)
Correct. Pump failure with pulmonary congestion and compensatory vasoconstriction.
B. Low cardiac output, low wedge pressure, raised systemic vascular resistance
This is the pattern of hypovolaemic shock, where the filling pressure is low.
C. High cardiac output, low wedge pressure, low systemic vascular resistance
This is the pattern of distributive shock, with warm vasodilated skin.
D. High cardiac output, raised wedge pressure, normal systemic vascular resistance
A high output state does not produce hypotension with a cold, clammy patient.

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 Physiology question

What is the answer to this Physiology question?

The best answer is A, Low cardiac output, raised wedge pressure, raised systemic vascular resistance. Failure of the left ventricle reduces output and causes blood to back up into the pulmonary circulation, so the wedge pressure rises.

Why is "Low cardiac output, low wedge pressure, raised systemic vascular resi…" not the answer?

This is the pattern of hypovolaemic shock, where the filling pressure is low.

Why is "High cardiac output, low wedge pressure, low systemic vascular resist…" not the answer?

This is the pattern of distributive shock, with warm vasodilated skin.

Why is "High cardiac output, raised wedge pressure, normal systemic vascular…" not the answer?

A high output state does not produce hypotension with a cold, clammy patient.

What concept does this question test?

It tests Cardiovascular system: haemodynamic profile of cardiogenic shock in Physiology. The fall in output triggers intense sympathetic vasoconstriction, so resistance is high and the skin is cold.

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 Cardiovascular system: haemodynamic profile of cardiogenic shock?

For each system, sketch the key graph (pressure–volume loop, oxygen dissociation curve, nephron handling) and explain it aloud. Then use the flashcards and the other Physiology 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.