Cardiovascular system: distributive shock haemodynamics: practice question

A Physiology 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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Physiology · Cardiovascular system: distributive shock haemodynamics

Sample item

A 45-year-old woman with pneumonia has bounding pulses, warm flushed extremities, blood pressure 80/35 mmHg and a high cardiac output on echocardiography. Which haemodynamic pattern explains her hypotension?

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

The answer and the reasoning

D. Low systemic vascular resistance with raised cardiac output

In septic (distributive) shock, mediator-driven vasodilatation lowers systemic vascular resistance and the diastolic pressure, so the pulse pressure widens and the extremities stay warm. Cardiac output is raised to compensate but cannot restore pressure. Cold, clammy skin with a low output is the pattern of cardiogenic and hypovolaemic shock.

Option by option

  • A. High systemic vascular resistance with low cardiac output

    High resistance with low output is the picture of hypovolaemic or cardiogenic shock, with cold peripheries.

  • B. Obstruction to ventricular outflow with a high afterload

    Outflow obstruction would give a low output and a narrow, not wide, pulse pressure.

  • C. Raised preload with falling contractility from pump failure

    Pump failure gives a low cardiac output, which does not fit the echocardiographic finding.

  • D. Low systemic vascular resistance with raised cardiac output (correct)

    Correct. Pressure falls because vascular resistance collapses despite a high output.

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.

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Questions about this Physiology question

What is the answer to this Physiology question?

The best answer is D, Low systemic vascular resistance with raised cardiac output. In septic (distributive) shock, mediator-driven vasodilatation lowers systemic vascular resistance and the diastolic pressure, so the pulse pressure widens and the extremities stay warm.

Why is "High systemic vascular resistance with low cardiac output" not the answer?

High resistance with low output is the picture of hypovolaemic or cardiogenic shock, with cold peripheries.

Why is "Obstruction to ventricular outflow with a high afterload" not the answer?

Outflow obstruction would give a low output and a narrow, not wide, pulse pressure.

Why is "Raised preload with falling contractility from pump failure" not the answer?

Pump failure gives a low cardiac output, which does not fit the echocardiographic finding.

What concept does this question test?

It tests Cardiovascular system: distributive shock haemodynamics in Physiology. Cardiac output is raised to compensate but cannot restore pressure. Cold, clammy skin with a low output is the pattern of cardiogenic and hypovolaemic shock.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Cardiovascular system: distributive shock haemodynamics?

For each system, sketch the key graph (pressure–volume loop, oxygen dissociation curve, nephron handling) and explain it aloud. Then use the flashcards and the other Physiology 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.