Shock: septic shock management: 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 · Shock: septic shock management

Sample item

A patient with pneumonia has fever, a pulse of 120 per minute and BP of 80/50 mmHg and lactate 4 mmol/L. After the first litre of fluid, which is the first-line vasopressor if hypotension persists?

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

The answer and the reasoning

A. Norepinephrine

Septic shock management consists of early broad-spectrum antibiotics within one hour, source control, an initial crystalloid bolus of about 30 mL/kg, and vasopressors to keep the mean arterial pressure at 65 mmHg or higher. Norepinephrine is the first-line vasopressor, and vasopressin may be added. Hydrocortisone is considered in refractory shock.

Option by option

  • A. Norepinephrine (correct)

    Correct. Norepinephrine is the vasopressor of choice.

  • B. Isoprenaline

    Isoprenaline is a vasodilating inotrope.

  • C. Dopamine as first choice

    Dopamine is associated with more arrhythmias and is second line.

  • D. Phenylephrine

    Phenylephrine is not preferred in septic 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 General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Norepinephrine. Septic shock management consists of early broad-spectrum antibiotics within one hour, source control, an initial crystalloid bolus of about 30 mL/kg, and vasopressors to keep the mean arterial pressure at 65 mmHg or higher.

Why is "Isoprenaline" not the answer?

Isoprenaline is a vasodilating inotrope.

Why is "Dopamine as first choice" not the answer?

Dopamine is associated with more arrhythmias and is second line.

Why is "Phenylephrine" not the answer?

Phenylephrine is not preferred in septic shock.

What concept does this question test?

It tests Shock: septic shock management in General Surgery. Norepinephrine is the first-line vasopressor, and vasopressin may be added. Hydrocortisone is considered in refractory 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 Shock: septic shock management?

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.