Mcq's on shock
MCQs on Shock
B. Increased cardiac output
C. Inadequate tissue perfusion
D. Excessive oxygenation
✅ Answer: C. Inadequate tissue perfusion
2. Which of the following is NOT a type of shock?
A. Cardiogenic shock
B. Neurogenic shock
C. Osteogenic shock
D. Hypovolemic shock
✅ Answer: C. Osteogenic shock
3. What type of shock results from severe blood or fluid loss?
A. Septic
B. Hypovolemic
C. Cardiogenic
D. Neurogenic
✅ Answer: B. Hypovolemic
4. Which condition is the most common cause of cardiogenic shock?
A. Stroke
B. Myocardial infarction
C. Sepsis
D. Hemorrhage
✅ Answer: B. Myocardial infarction
5. Septic shock is usually caused by:
A. Allergic reactions
B. Blood loss
C. Bacterial infection
D. Heart attack
✅ Answer: C. Bacterial infection
6. Which of the following is a sign of anaphylactic shock?
A. Bradycardia
B. Dry skin
C. Urticaria and wheezing
D. Hypoglycemia
✅ Answer: C. Urticaria and wheezing
7. In neurogenic shock, the cause is primarily:
A. Bacterial toxins
B. Heart pump failure
C. Spinal cord injury
D. Dehydration
✅ Answer: C. Spinal cord injury
8. Which type of shock is due to poor heart function?
A. Cardiogenic
B. Hypovolemic
C. Septic
D. Anaphylactic
✅ Answer: A. Cardiogenic
9. The early indicator of shock is usually:
A. Cold extremities
B. Low pulse
C. Restlessness or anxiety
D. Dilated pupils
✅ Answer: C. Restlessness or anxiety
10. What is the most important initial step in treating any type of shock?
A. Administer antibiotics
B. Identify the cause
C. Maintain airway and oxygenation
D. Start dialysis
✅ Answer: C. Maintain airway and oxygenation
11. Which lab value is elevated in septic shock?
A. Hemoglobin
B. Lactate
C. Calcium
D. Sodium
✅ Answer: B. Lactate
12. Vasopressors are used in shock to:
A. Lower blood pressure
B. Increase perfusion by constricting blood vessels
C. Reduce heart rate
D. Promote bleeding
✅ Answer: B. Increase perfusion by constricting blood vessels
13. What is the preferred fluid for resuscitation in hypovolemic shock?
A. Normal saline
B. Dextrose 5%
C. Sterile water
D. Albumin
✅ Answer: A. Normal saline
14. Which shock shows warm extremities in the early stage?
A. Cardiogenic
B. Septic
C. Hypovolemic
D. Neurogenic
✅ Answer: B. Septic
15. Bradycardia is most commonly seen in which shock type?
A. Septic
B. Hypovolemic
C. Neurogenic
D. Anaphylactic
✅ Answer: C. Neurogenic
16. What hormone plays a key role in compensatory mechanisms during shock?
A. Insulin
B. Adrenaline
C. Estrogen
D. Thyroxine
✅ Answer: B. Adrenaline
17. What is a classic symptom of hypovolemic shock?
A. Hypertension
B. Bounding pulse
C. Dry mucous membranes
D. Flushed skin
✅ Answer: C. Dry mucous membranes
18. Which type of shock involves hypersensitivity and allergic reactions?
A. Cardiogenic
B. Anaphylactic
C. Septic
D. Obstructive
✅ Answer: B. Anaphylactic
19. Pulmonary embolism can lead to:
A. Hypovolemic shock
B. Cardiogenic shock
C. Obstructive shock
D. Septic shock
✅ Answer: C. Obstructive shock
20. What is used to monitor the effectiveness of fluid resuscitation?
A. Heart sounds
B. Urine output
C. Skin turgor
D. Oxygen saturation only
✅ Answer: B. Urine output
21. The term “cold shock” is usually associated with:
A. Anaphylaxis
B. Early septic shock
C. Late septic shock
D. Neurogenic shock
✅ Answer: C. Late septic shock
22. Which electrolyte imbalance is common in prolonged shock?
A. Hyperkalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypoglycemia
✅ Answer: A. Hyperkalemia
23. Which of the following is NOT a component of the “Sepsis Six” bundle?
A. Oxygen
B. Blood cultures
C. Antibiotics
D. Antihistamines
✅ Answer: D. Antihistamines
24. Which vasopressor is first-line in septic shock?
A. Epinephrine
B. Norepinephrine
C. Dopamine
D. Phenylephrine
✅ Answer: B. Norepinephrine
25. Which organ is most sensitive to hypoperfusion in shock?
A. Liver
B. Brain
C. Lungs
D. Skin
✅ Answer: B. Brain
26. Which of the following indicates progression to irreversible shock?
A. Increased urine output
B. Normal mental status
C. Multi-organ failure
D. Normal blood pressure
✅ Answer: C. Multi-organ failure
27. Which type of shock is characterized by an allergic reaction to an antigen?
A. Cardiogenic
B. Anaphylactic
C. Neurogenic
D. Obstructive
✅ Answer: B. Anaphylactic
28. The compensatory stage of shock involves all EXCEPT:
A. Tachycardia
B. Vasoconstriction
C. Hypotension
D. Increased respiratory rate
✅ Answer: C. Hypotension
29. A hallmark feature of neurogenic shock is:
A. Hypertension
B. Bradycardia
C. Tachypnea
D. Hyperthermia
✅ Answer: B. Bradycardia
30. In hypovolemic shock, the central venous pressure (CVP) is:
A. Increased
B. Decreased
C. Normal
D. Unaffected
✅ Answer: B. Decreased
31. Which of the following is a cause of obstructive shock?
A. Myocardial infarction
B. Cardiac tamponade
C. Dehydration
D. Infection
✅ Answer: B. Cardiac tamponade
32. Which system is activated during shock to maintain blood pressure?
A. Immune system
B. Renin-angiotensin-aldosterone system
C. Lymphatic system
D. Digestive system
✅ Answer: B. Renin-angiotensin-aldosterone system
33. A patient with septic shock may initially present with:
A. Pale, cool skin
B. Bradycardia
C. Warm, flushed skin
D. Seizures
✅ Answer: C. Warm, flushed skin
34. Which drug class is used to treat anaphylactic shock?
A. Beta-blockers
B. Diuretics
C. Antihistamines and epinephrine
D. Antivirals
✅ Answer: C. Antihistamines and epinephrine
35. What diagnostic test helps confirm cardiac causes of shock?
A. Chest X-ray
B. CT scan
C. ECG and echocardiography
D. MRI
✅ Answer: C. ECG and echocardiography
36. A late sign of shock includes:
A. Pale skin
B. Decreased blood pressure
C. Increased respiratory rate
D. Irritability
✅ Answer: B. Decreased blood pressure
37. In the progressive stage of shock:
A. Tissue perfusion is restored
B. Organs begin to fail
C. Blood pressure returns to normal
D. All systems stabilize
✅ Answer: B. Organs begin to fail
38. One of the first treatments in hypovolemic shock is:
A. Beta blockers
B. IV fluid resuscitation
C. Antihistamines
D. Insulin
✅ Answer: B. IV fluid resuscitation
39. A major cause of death in septic shock is:
A. Liver failure
B. Multi-organ dysfunction
C. Head trauma
D. Hyperglycemia
✅ Answer: B. Multi-organ dysfunction
40. An early cardiovascular response to shock is:
A. Decreased heart rate
B. Vasodilation
C. Increased heart rate (tachycardia)
D. Decreased stroke volume
✅ Answer: C. Increased heart rate (tachycardia)
41. What clinical tool is used to assess organ dysfunction in sepsis and shock?
A. ABG
B. ECG
C. SOFA score
D. BMI
✅ Answer: C. SOFA score
42. Which organ is the least affected in the early stage of shock?
A. Brain
B. Kidneys
C. Skin
D. Muscles
✅ Answer: D. Muscles
43. What is a major complication of prolonged shock?
A. Stroke
B. Diabetes
C. Multi-organ failure
D. Hypertension
✅ Answer: C. Multi-organ failure
44. Which fluid is most commonly used in shock resuscitation?
A. Dextrose 5%
B. Ringer’s lactate
C. Normal saline
D. Albumin
✅ Answer: C. Normal saline
45. Which is a non-cardiac cause of cardiogenic shock?
A. Pulmonary embolism
B. Sepsis
C. Arrhythmias
D. Hemorrhage
✅ Answer: C. Arrhythmias
46. Tachypnea is a compensatory response to:
A. Low carbon dioxide
B. High pH
C. Metabolic acidosis
D. Increased perfusion
✅ Answer: C. Metabolic acidosis
47. A patient with altered mental status and hypotension may be in:
A. Stable condition
B. Early sepsis
C. Shock
D. Recovery
✅ Answer: C. Shock
48. Which lab test reflects tissue hypoxia in shock?
A. Serum sodium
B. Blood glucose
C. Serum lactate
D. Hematocrit
✅ Answer: C. Serum lactate
49. The most common cause of death in anaphylactic shock is:
A. Heart failure
B. Kidney failure
C. Airway obstruction
D. Brain hemorrhage
✅ Answer: C. Airway obstruction
50. In children, the first sign of shock is usually:
A. Low blood pressure
B. Cold extremities
C. Tachycardia
D. Cyanosis
✅ Answer: C. Tachycardia
51. Which of the following is not a classification of shock?
A. Cardiogenic
B. Hypovolemic
C. Neurogenic
D. Diabetic
✅ Answer: D. Diabetic
52. Which parameter is most indicative of tissue perfusion in shock?
A. Blood pressure
B. Respiratory rate
C. Urine output
D. Oxygen saturation
✅ Answer: C. Urine output
53. Which stage of shock is characterized by cellular injury and lactic acidosis?
A. Initial stage
B. Compensated stage
C. Progressive stage
D. Recovery stage
✅ Answer: C. Progressive stage
54. Hypotension in shock is primarily due to:
A. Increased preload
B. Increased afterload
C. Decreased cardiac output
D. Increased vascular resistance
✅ Answer: C. Decreased cardiac output
55. What ECG change is commonly seen in cardiogenic shock?
A. ST-segment elevation
B. Tall T-waves
C. Prolonged PR interval
D. U waves
✅ Answer: A. ST-segment elevation
56. Which of the following would be a late sign of hypovolemic shock?
A. Cool extremities
B. Narrow pulse pressure
C. Hypotension
D. Tachycardia
✅ Answer: C. Hypotension
57. Neurogenic shock is due to:
A. Myocardial infarction
B. Loss of sympathetic tone
C. Dehydration
D. Infection
✅ Answer: B. Loss of sympathetic tone
58. What is the primary goal of shock treatment?
A. Sedation
B. Vasodilation
C. Restore tissue perfusion
D. Decrease cardiac output
✅ Answer: C. Restore tissue perfusion
59. Which electrolyte imbalance is most dangerous in shock?
A. Hypocalcemia
B. Hypokalemia
C. Hyperkalemia
D. Hyponatremia
✅ Answer: C. Hyperkalemia
60. Which organ is most sensitive to decreased perfusion during shock?
A. Kidney
B. Liver
C. Brain
D. Lungs
✅ Answer: C. Brain
61. Which of the following is a non-hemorrhagic cause of hypovolemic shock?
A. Burns
B. GI bleeding
C. Trauma
D. Ruptured spleen
✅ Answer: A. Burns
62. Septic shock is most commonly caused by:
A. Viruses
B. Fungi
C. Bacteria
D. Parasites
✅ Answer: C. Bacteria
63. A patient with anaphylactic shock will most likely need:
A. Diuretics
B. Vasodilators
C. Epinephrine
D. Antacids
✅ Answer: C. Epinephrine
64. What is the main feature of compensated shock?
A. Bradycardia
B. Respiratory failure
C. Normal blood pressure
D. Organ dysfunction
✅ Answer: C. Normal blood pressure
65. Which cytokine plays a major role in septic shock?
A. Interleukin-10
B. Tumor Necrosis Factor-alpha (TNF-α)
C. Erythropoietin
D. Calcitonin
✅ Answer: B. Tumor Necrosis Factor-alpha (TNF-α)
66. The presence of which condition complicates septic shock the most?
A. Renal failure
B. Fever
C. Leukocytosis
D. Nausea
✅ Answer: A. Renal failure
67. Vasopressors are indicated in shock when:
A. Blood pressure is normal
B. Fluids have failed to restore BP
C. Patient has edema
D. Oxygen saturation is high
✅ Answer: B. Fluids have failed to restore BP
68. What is the first-line vasopressor used in septic shock?
A. Dopamine
B. Norepinephrine
C. Epinephrine
D. Vasopressin
✅ Answer: B. Norepinephrine
69. In obstructive shock, the heart is unable to fill due to:
A. Dehydration
B. Vasodilation
C. External pressure
D. High oxygen saturation
✅ Answer: C. External pressure
70. What is a sign of decompensated shock?
A. Elevated BP
B. Tachycardia
C. Warm skin
D. Altered mental status
✅ Answer: D. Altered mental status
71. What is the role of oxygen therapy in shock?
A. Decrease pH
B. Improve tissue oxygenation
C. Reduce heart rate
D. Stop bleeding
✅ Answer: B. Improve tissue oxygenation
72. Which lab finding is a sign of anaerobic metabolism in shock?
A. Low hemoglobin
B. High lactate
C. High WBC count
D. Low calcium
✅ Answer: B. High lactate
73. Which fluid is preferred in initial treatment of hypovolemic shock?
A. Hypertonic saline
B. Normal saline
C. D5W
D. Mannitol
✅ Answer: B. Normal saline
74. What is the significance of pulse pressure in shock diagnosis?
A. Narrowing indicates worsening shock
B. Widening suggests vasoconstriction
C. It has no clinical value
D. It reflects blood sugar
✅ Answer: A. Narrowing indicates worsening shock
75. Which imaging is most helpful in suspected obstructive shock due to PE?
A. Chest X-ray
B. Ultrasound
C. CT pulmonary angiography
D. MRI
✅ Answer: C. CT pulmonary angiography
76. Which of the following is not a feature of septic shock?
A. Fever
B. Hypotension
C. Bradycardia
D. Warm peripheries (early stage)
✅ Answer: C. Bradycardia
77. What is the hallmark sign of hypovolemic shock?
A. Bradycardia
B. Increased cardiac output
C. Decreased preload
D. Peripheral cyanosis
✅ Answer: C. Decreased preload
78. What does "MODS" stand for in critical care?
A. Multiple organ dysfunction syndrome
B. Moderate oxygen delivery system
C. Myocardial obstruction and dilation syndrome
D. Major orthopedic disease syndrome
✅ Answer: A. Multiple organ dysfunction syndrome
79. The primary mechanism in cardiogenic shock is:
A. Blood loss
B. Vasodilation
C. Cardiac pump failure
D. Sepsis
✅ Answer: C. Cardiac pump failure
80. Which clinical finding is common in neurogenic shock?
A. Hypertension
B. Warm skin and bradycardia
C. Sweating and tachycardia
D. Tachypnea and pallor
✅ Answer: B. Warm skin and bradycardia
81. Which receptor does norepinephrine primarily stimulate in shock management?
A. Beta-2
B. Alpha-1
C. Dopamine
D. Histamine
✅ Answer: B. Alpha-1
82. The most important early sign of shock is:
A. Cyanosis
B. Bradycardia
C. Tachycardia
D. Hypothermia
✅ Answer: C. Tachycardia
83. In distributive shock, systemic vascular resistance is:
A. Increased
B. Decreased
C. Normal
D. Absent
✅ Answer: B. Decreased
84. Which fluid is considered a colloid?
A. Ringer’s lactate
B. Dextrose 5%
C. Albumin
D. Normal saline
✅ Answer: C. Albumin
85. Which of the following is not typically part of the "shock triad"?
A. Hypotension
B. Hypothermia
C. Coagulopathy
D. Hypernatremia
✅ Answer: D. Hypernatremia
86. What is the Glasgow Coma Scale used to assess in shock patients?
A. Cardiac output
B. Renal function
C. Consciousness level
D. Hemorrhage severity
✅ Answer: C. Consciousness level
87. Which type of shock can result from spinal cord injury?
A. Hypovolemic
B. Neurogenic
C. Cardiogenic
D. Septic
✅ Answer: B. Neurogenic
88. What is the common pulse characteristic in early hypovolemic shock?
A. Bounding and strong
B. Rapid and thready
C. Slow and full
D. Irregular and slow
✅ Answer: B. Rapid and thready
89. Which of the following best defines shock?
A. Low BP
B. Inadequate oxygen delivery to tissues
C. Fever and dehydration
D. Rapid heart rate
✅ Answer: B. Inadequate oxygen delivery to tissues
90. Which organ is usually first affected by shock?
A. Brain
B. Lungs
C. Kidneys
D. Skin
✅ Answer: C. Kidneys
91. What is the mainstay treatment for anaphylactic shock?
A. Corticosteroids
B. IV fluids
C. Epinephrine
D. Antihistamines
✅ Answer: C. Epinephrine
92. Which diagnostic test is crucial in identifying internal bleeding in shock?
A. MRI
B. FAST ultrasound
C. EEG
D. ECG
✅ Answer: B. FAST ultrasound
93. Which of the following is a compensatory mechanism in early shock?
A. Decreased respiratory rate
B. Decreased heart rate
C. Vasodilation
D. Increased sympathetic tone
✅ Answer: D. Increased sympathetic tone
94. A patient presents with hypotension, distended neck veins, and muffled heart sounds. What is the most likely diagnosis?
A. Septic shock
B. Cardiac tamponade (obstructive shock)
C. Myocardial infarction
D. PE
✅ Answer: B. Cardiac tamponade (obstructive shock)
95. Which condition is most commonly associated with obstructive shock?
A. Cardiac arrest
B. Pulmonary embolism
C. Dehydration
D. Infection
✅ Answer: B. Pulmonary embolism
96. During shock, the acid-base imbalance seen is usually:
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
✅ Answer: C. Metabolic acidosis
97. Which of the following is not a direct cause of obstructive shock?
A. Tension pneumothorax
B. Cardiac tamponade
C. Myocardial infarction
D. Pulmonary embolism
✅ Answer: C. Myocardial infarction
98. What is the most effective first aid step for a person in shock?
A. Offer them water
B. Keep them standing
C. Lay them flat and elevate legs
D. Apply cold packs
✅ Answer: C. Lay them flat and elevate legs
99. Which lab marker is used to assess the severity of sepsis-related shock?
A. Sodium
B. Creatinine
C. Lactate
D. Hemoglobin
✅ Answer: C. Lactate
100. Which one of the following is a common cause of shock in elderly patients?
A. Minor trauma
B. Dehydration
C. Infection
D. All of the above
✅ Answer: D. All of the above
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