NBME 20 Early septic shock (NBME Answers)

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submitted by hayayah(1056),

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smc213 Septic shock can also present with hypothermia <36C +3

bethune Why is it not gastrointestinal bleeding? +3

beanie368 GI bleeding would present with increased SVR as a response to hypovolemia +5

mysteriousmantyping Why would this not be pulmonary embolism? +

step1passfail Pulmonary embolism would cause a decrease in cardiac output. There is increased pressure in the high compliant RV which can bulge and compress the LV, decreasing its preload. CO=Heart rate x stroke volume and stroke volume is partially determined by preload. If the pulmonary embolism is large enough, it can also obstruct the pulmonary vessels and subsequently not have enough blood going to the LA and LV, ultimately making the cardiac output near 0. +1