Shock - Complete MCQs with Answers and Explanations

1. Shock is best defined as:

A. Drop in blood pressure

B. Inadequate tissue perfusion

C. Loss of consciousness

D. Cyanosis

Answer: B. Inadequate tissue perfusion

Explanation: Shock is a state of circulatory failure resulting in insufficient oxygen delivery to tissues,

leading to cellular hypoxia.

2. The earliest sign of hypovolemic shock is:

A. Hypotension

B. Bradycardia

C. Tachycardia

D. Decreased urine output

Answer: C. Tachycardia

Explanation: The body compensates for volume loss by increasing heart rate to maintain cardiac

output before blood pressure falls.

3. Which of the following is characteristic of early septic shock?

A. Cold clammy skin

B. Warm extremities and bounding pulse

C. Cyanosis

D. Low cardiac output

Answer: B. Warm extremities and bounding pulse

Explanation: In early septic shock, vasodilation causes warm skin and bounding pulses. This is

known as 'warm shock'.

4. Best marker to monitor improvement in tissue perfusion during shock:

B. Urine output

C. Serum lactate

D. Capillary refill

Answer: C. Serum lactate

Explanation: Elevated lactate indicates anaerobic metabolism. Its decrease shows improved

perfusion.

5. Narrow pulse pressure is typical of:

A. Septic shock

B. Anaphylactic shock

C. Cardiogenic shock

D. Hypovolemic shock

Answer: D. Hypovolemic shock

Explanation: In hypovolemia, systolic BP drops more than diastolic, narrowing the pulse pressure.

6. Type of shock due to spinal cord injury:

A. Septic

B. Cardiogenic

C. Hypovolemic

D. Neurogenic

Answer: D. Neurogenic

Explanation: Damage to the spinal cord disrupts sympathetic tone, leading to hypotension and

bradycardia hallmark of neurogenic shock.

7. First-line vasopressor in septic shock unresponsive to fluids:

A. Dopamine

B. Epinephrine

C. Norepinephrine
D. Dobutamine

Answer: C. Norepinephrine

Explanation: Norepinephrine is the preferred drug for vasoconstriction in septic shock with

hypotension after fluid resuscitation.

8. Becks triad is seen in:

A. Anaphylactic shock

B. Cardiac tamponade

C. Tension pneumothorax

D. Hypovolemic shock

Answer: B. Cardiac tamponade

Explanation: Becks triad = hypotension, muffled heart sounds, distended neck veins classic for

cardiac tamponade.

9. What is the most common cause of cardiogenic shock?

A. Cardiac tamponade

B. Myocardial infarction

C. Tension pneumothorax

D. Pulmonary embolism

Answer: B. Myocardial infarction

Explanation: MI leads to pump failure, reducing cardiac output drastically and resulting in

cardiogenic shock.

10. Distributive shock includes all EXCEPT:

A. Septic shock

B. Anaphylactic shock

C. Neurogenic shock

D. Hypovolemic shock

Answer: D. Hypovolemic shock

Hypovolemic shock is due to fluid loss.

11. Correct order of treatment in hypovolemic shock:

A. Oxygen IV fluids Identify cause

B. Blood transfusion Antibiotics Surgery

C. Vasopressors Fluids Oxygen

D. Steroids Vasopressors Blood

Answer: A. Oxygen IV fluids Identify cause

Explanation: Stabilize the patient with oxygen and volume replacement before identifying the

underlying cause.

12. A patient in an accident has cold clammy skin, tachycardia, and hypotension. Likely

shock?

A. Septic

B. Anaphylactic

C. Hypovolemic

D. Neurogenic

Answer: C. Hypovolemic

Explanation: Features like cool peripheries, low BP, and tachycardia point to volume loss classic for

hypovolemic shock.

13. Which is NOT a typical sign of anaphylactic shock?

A. Bronchospasm

B. Urticaria

C. Hypertension

D. Angioedema

Answer: C. Hypertension

Explanation: Anaphylactic shock causes vasodilation and hypotension not hypertension.

A. Norepinephrine

B. Dopamine

C. Epinephrine

D. Atropine

Answer: C. Epinephrine

Explanation: Epinephrine counteracts bronchospasm, vasodilation, and hypotension in anaphylaxis.

15. Which shock shows bradycardia instead of tachycardia?

A. Cardiogenic

B. Septic

C. Neurogenic

D. Anaphylactic

Answer: C. Neurogenic

Explanation: Loss of sympathetic tone in neurogenic shock leads to bradycardia and hypotension a

key differentiator.

16. Which parameter is most useful to monitor fluid resuscitation in shock?

A. Pulse rate

B. Blood pressure

C. Central venous pressure (CVP)

D. Respiratory rate

Answer: C. Central venous pressure (CVP)

Explanation: CVP helps assess right atrial pressure and guides fluid therapy during resuscitation.

17. In hypovolemic shock, what is the typical change in hematocrit?

A. Decreased

B. Increased

C. No change
D. Initially increased, then decreased

Answer: D. Initially increased, then decreased

Explanation: Initially hemoconcentration occurs, later dilution with fluid therapy may decrease

hematocrit.

18. What is the hallmark of irreversible shock?

A. Hypotension

B. Tachycardia

C. Multiorgan failure

D. Oliguria

Answer: C. Multiorgan failure

Explanation: In irreversible shock, tissue damage progresses to organ failure despite treatment.

19. Neurogenic shock results from injury to which part of spinal cord?

A. Cervical

B. Thoracic

C. Lumbar

D. Sacral

Answer: A. Cervical

Explanation: High spinal cord injuries (especially cervical) can impair sympathetic outflow, leading to

neurogenic shock.

20. Which of the following is NOT a type of shock?

A. Septic

B. Hemorrhagic

C. Obstructive

D. Metabolic

Answer: D. Metabolic

Explanation: Metabolic imbalance may occur in shock, but it is not a shock type. Shock types
include hypovolemic, cardiogenic, obstructive, and distributive.