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NBME 22 Answers

nbme22/Block 1/Question#23

A patient in the early stages of hemorrhagic shock ...

A weak pulse due to decreased stroke volume

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 +2  upvote downvote
submitted by dr.xx(42),

Hypovolemia is a direct loss of effective circulating blood volume leading to:

  • A rapid, weak, thready pulse due to decreased blood flow combined with tachycardia
  • Cool, clammy skin due to vasoconstriction and stimulation of vasoconstriction
  • Rapid and shallow breathing due to sympathetic nervous system stimulation and acidosis
  • Hypothermia due to decreased perfusion and evaporation of sweat
  • Thirst and dry mouth, due to fluid depletion
  • Cold and mottled skin (Livedo reticularis), especially extremities, due to insufficient perfusion of the skin


 -2  upvote downvote
submitted by atstillisafraud(50),

Ambiguous question but in because it is early shock, there is not enough time to activate the RAAS to increase kidney perfusion.