Shock Management

Question 1

(“What is shock?”

Answer 1

“Shock is a life-threatening condition where the circulatory system fails to deliver enough oxygen and nutrients to meet the body’s needs.”)

Question 2

(“What are the main types of shock?”

Answer 2

“Hypovolemic

Question 3

(“What are the key indicators of shock management?”

Answer 3

“Blood pressure

Question 4

(“What is the systolic blood pressure goal in shock for a child under 1 month?”

Answer 4

“At least 60 mmHg.”)

Question 5

(“What is the systolic blood pressure goal in shock for children 1 month to 10 years?”

Answer 5

“70 mmHg + (2 x age in years).”)

Question 6

(“What is the systolic blood pressure goal in shock for children over 10 years?”

Answer 6

“90 mmHg.”)

Question 7

(“What is the target urine output in shock management?”

Answer 7

“≥0.5 mL/kg/hr

Question 8

(“What is the target CVP in shock management?”

Answer 8

“8–12 mmHg.”)

Question 9

(“What is the target MAP in shock management?”

Answer 9

“≥65 mmHg.”)

Question 10

(“What is the target cardiac index (CI) in shock management?”

Answer 10

“3.3-6 L/min.”)

Question 11

(“What is the target central venous oxygen saturation (SvO2) in shock?”

Answer 11

“>70%.”)

Question 12

(“What does ABC stand for in shock management?”

Answer 12

“Airway

Question 13

(“When should early intubation and ventilation be considered in shock?”

Answer 13

“If the patient’s airway is not patent.”)

Question 14

(“What oxygen therapy is recommended in shock?”

Answer 14

“100% oxygen should be delivered.”)

Question 15

(“What is the initial fluid resuscitation for unclassified shock?”

Answer 15

“20 mL/kg bolus of normal saline (N/S) or Ringer’s lactate solution.”)

Question 16

(“What are the two types of hypovolemic shock?”

Answer 16

“Non-hemorrhagic and Hemorrhagic shock.”)

Question 17

(“What is the fluid resuscitation recommendation for non-hemorrhagic hypovolemic shock?”

Answer 17

“20 mL/kg

Question 18

(“What is the first-line vasopressor for fluid-refractory hypovolemic shock?”

Answer 18

“Dopamine at 5-20 mcg/kg/min.”)

Question 19

(“What is the alternative vasopressor for dopamine-resistant fluid-refractory shock?”

Answer 19

“Epinephrine 0.05–0.3 mcg/kg/min.”)

Question 20

(“What steroid is used in catecholamine-resistant shock?”

Answer 20

“Hydrocortisone 50 mg/kg.”)

Question 21

(“What hemoglobin level should be targeted for transfusion in hemorrhagic shock?”

Answer 21

“≥10 g/dL.”)

Question 22

(“What is the recommended packed RBC transfusion bolus in hemorrhagic shock?”

Answer 22

“10 mL/kg boluses.”)

Question 23

(“What is the recommended FFP dose for correcting coagulopathy in hemorrhagic shock?”

Answer 23

“10 mL/kg.”)

Question 24

(“What should be ruled out in persistent catecholamine-resistant shock?”

Answer 24

“Pericardial effusion

Question 25

("What mechanical support is indicated for refractory shock?"

Answer 25

"Extracorporeal membrane oxygenation (ECMO) or a ventricular assist device.")

Question 26

("What is the key principle of hemorrhagic shock management?"

Answer 26

"Achieving hemostasis or 'source control'.")

Question 27

("What is the normal core temperature that should be maintained in hemorrhagic shock?"

Answer 27

">35°C.")

Question 28

("What is the primary treatment for septic shock?"

Answer 28

"Fluid resuscitation and infection control with empiric antibiotics.")

Question 29

("What is the first-line vasopressor for fluid-refractory septic shock?"

Answer 29

"Epinephrine 0.05–0.3 mcg/kg/min.")

Question 30

("What is the alternative vasopressor for warm septic shock?"

Answer 30

"Norepinephrine 0.05–1 mcg/kg/min

Question 31

("What should be considered in catecholamine-resistant septic shock?"

Answer 31

"Adrenal insufficiency; treat with hydrocortisone 50 mg/m² or 1–2 mg/kg per dose.")

Question 32

("What is the treatment for anaphylactic shock?"

Answer 32

"IM adrenaline 1:1000 at 0.01 mL/kg

Question 33

("What additional treatments are given for anaphylactic shock with stridor or wheezing?"

Answer 33

"Nebulized adrenaline and beta-2 agonists.")

Question 34

("What is the primary treatment for neurogenic shock?"

Answer 34

"Fluid resuscitation with 20 mL/kg boluses.")

Question 35

("What vasopressor is recommended for refractory neurogenic shock?"

Answer 35

"Norepinephrine 0.05-0.5 mcg/kg/min or Epinephrine 0.05–0.3 mcg/kg/min.")

Question 36

("What is the treatment for persistent bradycardia in neurogenic shock?"

Answer 36

"Atropine 0.2 mg/kg IV.")

Question 37

("What steroid is used in neurogenic shock?"

Answer 37

"Methylprednisolone.")

Question 38

("What are the main causes of cardiogenic shock?"

Answer 38

"Bradyarrhythmia

Question 39

("What is the first-line drug for bradyarrhythmia in cardiogenic shock?"

Answer 39

"IV Atropine 0.02 mg/kg

Question 40

("What is the recommended epinephrine dose for bradyarrhythmia in cardiogenic shock?"

Answer 40

"IV 0.01 mg/kg (0.1 mL/kg of 1:10

Question 41

("What is the first-line treatment for sinus tachycardia in cardiogenic shock?"

Answer 41

"Treat the underlying cause: fever

Question 42

("What drug is used for supraventricular tachycardia in cardiogenic shock?"

Answer 42

"IV Adenosine 0.1 mg/kg.")

Question 43

("What is the loading dose of amiodarone for wide QRS complex tachycardia?"

Answer 43

"5 mg/kg over 20–60 minutes.")

Question 44

("What is the initial fluid trial in cardiogenic shock?"

Answer 44

"Isotonic crystalloid fluid bolus of 5–10 mL/kg over 10–20 minutes.")

Question 45

("What inotrope is used if blood pressure is low in cardiogenic shock?"

Answer 45

"Dopamine 5-20 mcg/kg/min.")

Question 46

("What inotrope is used if cardiac output is low and blood pressure is normal or high?"

Answer 46

"Dobutamine 1–10 mcg/kg/min.")

Question 47

("What is the treatment for inotrope-resistant cardiogenic shock?"

Answer 47

"Milrinone 50 mcg/kg over 15 min

Question 48

("What is the primary treatment for tension pneumothorax in obstructive shock?"

Answer 48

"Needle decompression followed by chest tube placement.")

Question 49

("What is the primary treatment for cardiac tamponade in obstructive shock?"

Answer 49

"Pericardiocentesis.")

Question 50

("What is the primary treatment for pulmonary embolism in obstructive shock?"

Answer 50

"Thrombectomy or thrombolysis.")

Question 51

("What is the primary treatment for ductal-dependent left ventricular outflow obstruction in obstructive shock?"

Answer 51

"Prostaglandin infusion.")