USMLE Question of the Week

How to Understand Shock Physiology in an Infant

In Episode 34 of Med School Question of the Week for USMLE, Faustine Ramirez, MedSchoolCoach expert tutor, answers this medical school question: A 10-month-old boy is brought to the emergency department with one day of fever, irritability, and poor feeding. Temperature is 40 C, heart rate is 190/min, respiratory rate is 60/min, and blood pressure is 60/30. Extremities are warm, pulses are bounding, capillary refill is 4 seconds, and mucous membranes are dry. Blood cultures grow S. Aureus. Which of the following is the most likely mechanism for these findings?
  • Increased hydrostatic pressure
  • Decreased systemic vascular resistance
  • Increased pulmonary vascular resistance
  • Decreased cardiac output
  • Increased pulmonary capillary wedge pressure
  • Decreased oncotic pressure
Click to Reveal the Correct Answer

Decreased systemic vascular resistance

Faustine Ramirez

Faustine graduated from the University of Washington in Seattle with a B.A. in Medical Anthropology and Global Health. She attends medical school at University of California, San Francisco where she designed and taught a course on clinical reasoning skills, developed curriculum materials for the pre-clinical pediatrics course, and led case-based sessions in pediatrics and infectious disease. She received a 253 on Step 1 and a 266 on Step 2 CK, and she scored in the 90th percentiles on all of her shelf exams.

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