Haemodynamics: shock mechanism: 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: shock mechanism

Sample item

A 45-year-old with fever, hypotension and warm flushed extremities has a normal central venous pressure and a bounding pulse. Which mechanism underlies this shock?

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

The answer and the reasoning

D. Systemic vasodilation from cytokines and nitric oxide

In septic shock, TNF, IL-1 and nitric oxide cause vasodilation and capillary leak, with endothelial injury and DIC. Early features include warm extremities, in contrast with cold clammy skin in other shock types.

Option by option

  • A. Obstruction to ventricular filling

    Obstructive shock, as in tamponade, shows distended neck veins and cold skin.

  • B. Pump failure after myocardial infarction

    Cardiogenic shock shows a raised central venous pressure with cold extremities.

  • C. Reduced intravascular volume from haemorrhage

    Haemorrhage lowers central venous pressure and causes cold, pale skin from vasoconstriction.

  • D. Systemic vasodilation from cytokines and nitric oxide (correct)

    Correct. Cytokine-driven vasodilation causes warm shock in sepsis.

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 D, Systemic vasodilation from cytokines and nitric oxide. In septic shock, TNF, IL-1 and nitric oxide cause vasodilation and capillary leak, with endothelial injury and DIC.

Why is "Obstruction to ventricular filling" not the answer?

Obstructive shock, as in tamponade, shows distended neck veins and cold skin.

Why is "Pump failure after myocardial infarction" not the answer?

Cardiogenic shock shows a raised central venous pressure with cold extremities.

Why is "Reduced intravascular volume from haemorrhage" not the answer?

Haemorrhage lowers central venous pressure and causes cold, pale skin from vasoconstriction.

What concept does this question test?

It tests Haemodynamics: shock mechanism in Pathology. Early features include warm extremities, in contrast with cold clammy skin in other shock types.

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 Haemodynamics: shock mechanism?

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.