Emergencies: septic shock: practice question

A Pediatrics 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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Pediatrics · Emergencies: septic shock

Sample item

A child in septic shock has tachycardia, cold peripheries and prolonged capillary refill. Which is the initial fluid resuscitation?

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

The answer and the reasoning

A. Isotonic crystalloid bolus of 20 ml/kg, reassessing after each bolus

Early recognition and prompt fluid boluses of 10 to 20 ml/kg isotonic crystalloid, with reassessment for signs of overload, are used along with antibiotics within the first hour. Inotropes such as adrenaline are started if shock persists. Fluid bolus caution applies in severe malnutrition and severe febrile illness without shock.

Option by option

  • A. Isotonic crystalloid bolus of 20 ml/kg, reassessing after each bolus (correct)

    Correct. Isotonic crystalloid bolus with reassessment.

  • B. 5 percent dextrose 50 ml/kg

    Dextrose does not expand intravascular volume.

  • C. Albumin only

    Albumin is not first line.

  • D. Fluids restricted to maintenance

    Maintenance fluids do not treat shock.

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 Pediatrics question

What is the answer to this Pediatrics question?

The best answer is A, Isotonic crystalloid bolus of 20 ml/kg, reassessing after each bolus. Early recognition and prompt fluid boluses of 10 to 20 ml/kg isotonic crystalloid, with reassessment for signs of overload, are used along with antibiotics within the first hour.

Why is "5 percent dextrose 50 ml/kg" not the answer?

Dextrose does not expand intravascular volume.

Why is "Albumin only" not the answer?

Albumin is not first line.

Why is "Fluids restricted to maintenance" not the answer?

Maintenance fluids do not treat shock.

What concept does this question test?

It tests Emergencies: septic shock in Pediatrics. Inotropes such as adrenaline are started if shock persists. Fluid bolus caution applies in severe malnutrition and severe febrile illness without shock.

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 Emergencies: septic shock?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.