Trauma: haemorrhagic shock: practice question

A General Surgery 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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General Surgery · Trauma: haemorrhagic shock

Sample item

A trauma patient has a heart rate of 128 per minute, a respiratory rate of 32, a systolic blood pressure of 88 mmHg, and is confused. By ATLS classification, what is the approximate blood loss?

A15 to 30% (Class II)BLess than 15% (Class I)C30 to 40% of blood volume (Class III)DMore than 40% (Class IV)

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

The answer and the reasoning

C. 30 to 40% of blood volume (Class III)

In Class III haemorrhage, 30 to 40% of blood volume (about 1500 to 2000 mL) is lost, with tachycardia of 120 or more, falling blood pressure, tachypnoea, reduced urine output and anxiety or confusion. Class IV exceeds 40%, with marked hypotension, a weak pulse and obtundation. Management is bleeding control, blood product replacement and balanced resuscitation.

Option by option

A. 15 to 30% (Class II)
Class II has tachycardia but a preserved blood pressure.
B. Less than 15% (Class I)
Class I has normal vital signs.
C. 30 to 40% of blood volume (Class III) (correct)
Correct. Hypotension with confusion and tachycardia above 120 is Class III.
D. More than 40% (Class IV)
Class IV loss exceeds 40%, with a markedly low blood pressure, a pulse above 140 and lethargy, which is more severe than this picture.

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 General Surgery question

What is the answer to this General Surgery question?

The best answer is C, 30 to 40% of blood volume (Class III). In Class III haemorrhage, 30 to 40% of blood volume (about 1500 to 2000 mL) is lost, with tachycardia of 120 or more, falling blood pressure, tachypnoea, reduced urine output and anxiety or confusion.

Why is "15 to 30% (Class II)" not the answer?

Class II has tachycardia but a preserved blood pressure.

Why is "Less than 15% (Class I)" not the answer?

Class I has normal vital signs.

Why is "More than 40% (Class IV)" not the answer?

Class IV loss exceeds 40%, with a markedly low blood pressure, a pulse above 140 and lethargy, which is more severe than this picture.

What concept does this question test?

It tests Trauma: haemorrhagic shock in General Surgery. Class IV exceeds 40%, with marked hypotension, a weak pulse and obtundation. Management is bleeding control, blood product replacement and balanced resuscitation.

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 Trauma: haemorrhagic shock?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.