Shock and blood transfusion MCQs : Bailey and Love Surgery
Check our MCQs from the chapter on Shock and Blood transfusion from Bailey and Love Surgery textbook.
|1. Which of the following statements are false regarding hypovolemic shock?
A. The vascular resistance is high.
B. It is associated with high cardiac output.
C. The venous pressure is low.
D. The mixed venous saturation is low.
E. The base deficit is high.
Hypovolaemia: Hypovolaemic shock is due to a reduced circulating volume.
-Cardiac output: Low
-Vascular resistance: High
-Venous pressure: Low
-Mixed venous saturation: Low
-Base deficit: High
|2. Which is the most common type of shock encountered in surgical practice:
A. Cardiogenic Shock
B. Endocrine Shock
C. Hypovolemic Shock
D. Distributive Shock
|Answer: C Hypovolaemia is probably the most common form of shock
|3. All are true about Ischemia reperfusion syndrome except:
A. Injury that occurs once normal circulation is restored to hypoxic tissues
B. Sodium load that has built up can lead to direct myocardial depression and vascular dilatation
C. Reperfusion injury can currently only be attenuated by reducing the extent and duration of tissue hypoperfusion.
D. Influenced by the duration and extent of tissue hypoperfusion
|Answer: B Injury occurs once normal circulation is restored to these hypoxic tissues. The acid and potassium load that has built up can lead to direct myocardial depression, vascular dilatation and further hypotension. The cellular and humoral elements activated by the hypoxia (complement, neutrophils, microvascular thrombi) are flushed back into the circulation where they cause further endothelial injury to organs such as the lungs and the kidneys. This leads to acute lung injury, acute renal injury, multiple organ failure and death. Reperfusion injury can currently only be attenuated by reducing the extent and duration of tissue hypoperfusion.
|4. A Massive pulmonary embolus can lead to which type of shock:
A. Hypovolaemic shock
B. Cardiogenic shock
C. Obstructive shock
D. Distributive shock
|Answer: C In obstructive shock there is a reduction in preload due to mechanical obstruction of cardiac filling. Common causes of obstructive shock include cardiac tamponade, tension pneumothorax, massive pulmonary embolus or air embolus. In each case, there is reduced filling of the left and/or right sides of the heart leading to reduced preload and a fall in cardiac output.
|5. True statement about neurogenic shock
B. The patient has cold and moist extremity
C. It is due to parasympathetic cut off
D. It is a diagnosis of exclusion
|Answer: D It is the sudden loss of autonomic tone due to spinal cord injury. Disruption of descending sympathetic pathway leads to vasodilation and decreased vascular resistance. Patient has bradycardia and not tachycardia. Extremities are warm in these cases.
|6. Adrenal insufficiency can lead to which type of shock:
|Answer: D Adrenal insufficiency leads to shock due to hypovolaemia and a poor response to circulating and exogenous catecholamines. Adrenal insufficiency may be due to pre-existing Addison’s disease or be a relative insufficiency due to a pathological disease state, such as systemic sepsis.
|7. Which of the following statements is false regarding compensated shock?
A. Preload is preserved by the cardiovascular and endocrinal compensatory responses.
B. Tachycardia and cool peripheries may be the only clinical signs.
C. The perfusion to the skin, muscle and GI tract is decreased.
D. Patients with occult hypoperfusion for more than 36 hours have a significantly higher mortality rate
|Answer: D In Compensated shock, the body’s cardiovascular and endocrine compensatory responses reduce flow to non-essential organs to preserve preload and flow to the lungs and brain. Tachycardia and cool peripheries may be the only clinical signs. The perfusion to the skin, muscle and GI tract is decreased. Patients with occult hypoperfusion (metabolic acidosis despite normal urine output and cardiorespiratory vital signs) for more than 12 hours have a significantly higher mortality rate.
|8. Loss of what percent of blood is tolerated by physiological compensatory mechanisms?
|Answer: C In general, loss of around 15 per cent of the circulating blood volume is within normal compensatory mechanisms. Blood pressure is usually well maintained and only falls after 30–40 per cent of circulating volume has been lost.
|9. In case of septic shock which of the following statement is true?
A. The patient will have prolonged capillary refill times
B. There will be no effect on the capillary refill time
C. The capillary refill time will be brisk
D. Capillary refill time is an accurate measure of shock
|Answer: C Most patients in hypovolaemic shock will have cool, pale peripheries, with prolonged capillary refill times. However, the actual capillary refill time varies so much in adults that it is not a specific marker of whether a patient is shocked, and patients with short capillary refill times may be in the early stages of shock. In distributive (septic) shock, the peripheries will be warm and capillary refill will be brisk, despite profound shock.
Bailey and Love MCQs
- Chapter 1 – Metabolic Response to Injury
- Chapter 2 – Shock and Blood Transfusion
- Chapter 3 – Wound Healing and Tissue Repair
- Chapter 4 – Basic surgical skill and anastomoses
- Chapter 5 – Surgical Wound Infections
- Chapter 6 – Tropical Infections and Infestations