Shock

A 24-year-old with penetrating torso trauma is hypotensive (SBP 78), tachycardic, and mentating. Prehospital ETA 10 min. Best immediate target before hemorrhage control?

A 68-year-old with septic shock after perforated sigmoid diverticulitis received 30 mL/kg balanced crystalloids; MAP is 58 mmHg. Next best step?

A 56-year-old with anterior STEMI develops hypotension, cool extremities, pulmonary edema. Most appropriate hemodynamic support?

A 35-year-old asthmatic in the PACU has sudden hypotension, wheeze, urticaria after cefazolin. First-line treatment?

A 72-year-old with suspected PE is hypotensive (MAP 55), tachycardic, hypoxic, JVD present. POCUS shows dilated RV. Best immediate therapy?

In tension pneumothorax with obstructive shock, which emergent step is correct?

Which combination best defines the “lethal triad” in hemorrhagic shock?

A 28-year-old with pelvic fractures is hypotensive; FAST positive. Which adjunct improves survival when MTP initiated?

A 70-kg trauma patient is on MTP. Which electrolyte must be proactively replaced?

A 67-year-old post-laparotomy has septic shock. Beyond fluids/pressors, what timing for source control is appropriate?

Which bedside maneuver best predicts fluid responsiveness in shock?

A 54-year-old with high spinal cord injury is hypotensive (SBP 80) and bradycardic (HR 45), skin warm/dry. Most appropriate initial pressor?

A 60-year-old with cardiogenic shock from acute MI remains in low output despite norepinephrine and dobutamine. Next best escalation?

Which laboratory marker is most useful as an early prognostic indicator and resuscitation endpoint in shock?

A 45-year-old with blunt trauma is hypotensive with positive FAST. Most appropriate immediate pathway?

During septic shock resuscitation, vasopressin is best used how?

A 33-year-old postpartum patient collapses with hypotension, hypoxemia, seizures. Considered diagnosis?

In hemorrhagic shock without TBI, which fluid strategy is preferred?

A 62-year-old with perforated ulcer is hypotensive and oliguric after 2 L LR. Best next step if PLR shows no increase in stroke volume?

A classic Beck’s triad in tamponade includes which findings?

During anaphylactic shock with refractory hypotension after IM epinephrine and fluids, best IV vasopressor?

A 58-year-old septic patient has temperature 39°C, MAP 62 after fluids, mottled skin, lactate 6. Which arterial line target is appropriate?

Which parameter best distinguishes cardiogenic from distributive shock on hemodynamics?

Trauma patient with ongoing bleeding becomes hypothermic. Which step reduces iatrogenic hypothermia?

A 41-year-old with massive GI hemorrhage is on MTP. Which ratio strategy is correct?

A 52-year-old on chronic steroids develops refractory septic shock. Which adjunct is appropriate?

Which clinical index suggests occult shock despite “normal” vitals?

Which vasopressor is least appropriate as sole agent in cardiogenic shock?

Optimal timing of first-dose antibiotics in septic shock after recognition?

Patient with severe anaphylaxis on IM epinephrine remains hypotensive despite fluids. Best IV vasopressor?

Post–cardiac surgery patient has refractory vasoplegic shock despite high-dose catecholamines and vasopressin. Rescue option?

A 68-year-old with flash pulmonary edema and hypotension from acute MI is in respiratory distress. Best airway strategy?

In coagulopathic shock, which central access site is generally safest to minimize bleeding and pneumothorax?

In early septic shock, which ScvO₂ target indicates adequate oxygen delivery?

Massive bleeding after trauma: what is the correct TXA dosing strategy when indicated?

Corticosteroids in septic shock are indicated when hypotension persists despite fluids and vasopressors. Preferred regimen?

Starting vasopressors while awaiting central access in septic shock:

Choosing an inotrope in cardiogenic shock with hypotension and renal dysfunction:

Obstructive shock from massive PE with RV failure: preferred vasopressor to support MAP?

Acute severe MR due to papillary muscle rupture causing cardiogenic shock after MI. Best definitive strategy?

On controlled mechanical ventilation, which dynamic parameter suggests fluid responsiveness?

Severe hyperkalemia with wide QRS in shock and central access available. Which calcium salt is preferred?

Hemorrhagic shock with open-book pelvic fracture in ED. First stabilization step?

A patient with long-standing hypertension and septic shock develops oliguric AKI at MAP 65 mmHg. Best MAP strategy?