Critical care: hydrocortisone in refractory septic shock: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Critical care: hydrocortisone in refractory septic shock

Sample item

When is intravenous hydrocortisone suggested in septic shock?

AWhen ongoing vasopressor requirement persists despite fluids and norepinephrine, at about 200 mg per dayBFor all septic patients without shockCAs a single 1 g dose for every patientDOnly after the vasopressors are stopped

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. When ongoing vasopressor requirement persists despite fluids and norepinephrine, at about 200 mg per day

Hydrocortisone at about 200 mg/day is suggested for adults with septic shock and an ongoing vasopressor requirement. It hastens shock reversal in this group. It is not recommended for sepsis without shock.

Option by option

A. When ongoing vasopressor requirement persists despite fluids and norepinephrine, at about 200 mg per day (correct)
Correct. Persisting vasopressor need is the indication.
B. For all septic patients without shock
Sepsis without shock is not an indication.
C. As a single 1 g dose for every patient
A single large dose is not the recommended regimen.
D. Only after the vasopressors are stopped
Steroids are used while vasopressors are still required.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is A, When ongoing vasopressor requirement persists despite fluids and norepinephrine, at about 200 mg per day. Hydrocortisone at about 200 mg/day is suggested for adults with septic shock and an ongoing vasopressor requirement.

Why is "For all septic patients without shock" not the answer?

Sepsis without shock is not an indication.

Why is "As a single 1 g dose for every patient" not the answer?

A single large dose is not the recommended regimen.

Why is "Only after the vasopressors are stopped" not the answer?

Steroids are used while vasopressors are still required.

What concept does this question test?

It tests Critical care: hydrocortisone in refractory septic shock in Anaesthesia. It hastens shock reversal in this group. It is not recommended for sepsis without shock.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Critical care: hydrocortisone in refractory septic shock?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.