PATHO 370 Week 3 Pathophysiology Exam: Comprehensive 150-Question Bank with Verified
Answers and Detailed Explanations for Cardiovascular Disorders, Shock States, Hemodynamics, and
Systemic Complications – 2026 Updated Edition
Questions 1–150 (With Correct Answers & Explanations)
Section 1: Hemodynamics & Shock (Questions 1–30)
1. A patient with hypovolemic shock has a heart rate of 130 bpm and cool, clammy skin. This
compensatory mechanism is primarily mediated by:
A) Parasympathetic nervous system
B) Renin-angiotensin-aldosterone system
C) Sympathetic nervous system
D) Atrial natriuretic peptide
Correct Answer: C – Sympathetic activation increases heart rate and vasoconstriction (cool, clammy
skin) to maintain perfusion.
2. Which hemodynamic parameter is most decreased in early hypovolemic shock?
A) Systemic vascular resistance
B) Central venous pressure
C) Heart rate
D) Mean arterial pressure
Correct Answer: B – Central venous pressure (preload) drops first due to reduced intravascular
volume.
3. A patient in septic shock has warm, flushed skin and bounding pulses. This indicates:
A) High systemic vascular resistance
B) Early distributive shock with vasodilation
C) Compensated hypovolemia
D) Cardiogenic shock
Correct Answer: B – In early septic shock, cytokines cause vasodilation, leading to warm extremities
and bounding pulses.
4. The primary pathophysiologic problem in cardiogenic shock is:
A) Loss of sympathetic tone
, B) Severe hypovolemia
C) Pump failure with reduced cardiac output
D) Massive vasodilation
Correct Answer: C – Cardiogenic shock results from the heart’s inability to pump adequately, usually
after MI.
5. Which finding distinguishes cardiogenic shock from hypovolemic shock?
A) Tachycardia
B) Cool extremities
C) Elevated jugular venous pressure
D) Hypotension
Correct Answer: C – Elevated JVP indicates fluid backup (high preload) in cardiogenic shock;
hypovolemic shock has low JVP.
6. In neurogenic shock, hypotension occurs because of:
A) Decreased systemic vascular resistance
B) Decreased blood volume
C) Increased myocardial contractility
D) Increased afterload
Correct Answer: A – Loss of sympathetic tone causes unopposed vagal tone and massive vasodilation.
7. A patient with anaphylactic shock is given epinephrine. The primary desired effect is:
A) Bronchodilation only
B) Vasodilation and increased capillary permeability
C) Vasoconstriction and bronchodilation
D) Decreased heart rate
Correct Answer: C – Epinephrine is alpha-1 (vasoconstriction) and beta-2 (bronchodilation) agonist.
8. Lactic acidosis in shock states results from:
A) Increased hepatic clearance of lactate
B) Aerobic metabolism in muscles
C) Anaerobic metabolism due to tissue hypoxia
D) Respiratory alkalosis
Correct Answer: C – Poor tissue perfusion forces cells to switch to anaerobic glycolysis, producing
lactate.
9. The earliest indicator of adequate tissue perfusion in shock resuscitation is:
, A) Normal blood pressure
B) Urine output >0.5 mL/kg/hr
C) Heart rate <100 bpm
D) Warm extremities
Correct Answer: B – Urine output reflects renal perfusion and is a sensitive marker of end-organ
perfusion.
10. Mixed venous oxygen saturation (SvO2) is decreased in all types of shock except:
A) Hypovolemic
B) Cardiogenic
C) Septic (early, hyperdynamic phase)
D) Obstructive
Correct Answer: C – In early septic shock, high cardiac output and shunting may cause normal or high
SvO2.
11. Which medication is first-line for vasodilatory shock in adults?
A) Dopamine
B) Epinephrine
C) Norepinephrine
D) Phenylephrine
Correct Answer: C – Norepinephrine is guideline-recommended first-line vasopressor in septic and
vasodilatory shock.
12. Obstructive shock is most commonly caused by:
A) Myocardial infarction
B) Pulmonary embolism
C) Dehydration
D) Spinal cord injury
Correct Answer: B – Massive PE obstructs right ventricular outflow, reducing left ventricular filling.
13. Beck’s triad (hypotension, JVD, muffled heart sounds) is pathognomonic for:
A) Tension pneumothorax
B) Cardiac tamponade
C) Pulmonary embolism
D) Aortic dissection
Correct Answer: B – Pericardial fluid compresses the heart, impairing diastolic filling.
, 14. In hemorrhagic shock class III, expected blood loss is:
A) <15% of blood volume
B) 15–30%
C) 30–40%
D) >40%
Correct Answer: C – Class III (30–40% loss) causes significant tachycardia, hypotension, and oliguria.
15. The compensatory mechanism that increases preload in hypovolemic shock is:
A) Vasodilation
B) Tachycardia
C) Venous constriction
D) Bradycardia
Correct Answer: C – Venoconstriction mobilizes blood from capacitance vessels, increasing venous
return.
16. A patient in shock has a cardiac index <1.8 L/min/m² and PCWP >18 mmHg. This is consistent
with:
A) Hypovolemic shock
B) Distributive shock
C) Cardiogenic shock
D) Obstructive shock
Correct Answer: C – Low cardiac output with high filling pressures indicates pump failure.
17. In septic shock, elevated cardiac output with low systemic vascular resistance is seen in the:
A) Early or “warm” phase
B) Late or “cold” phase
C) Irreversible phase
D) Refractory phase
Correct Answer: A – Early distributive phase has vasodilation and compensatory high output.
18. Which laboratory finding suggests tissue hypoxia in shock?
A) Elevated pH
B) Elevated lactate
C) Low anion gap
D) Elevated bicarbonate
Answers and Detailed Explanations for Cardiovascular Disorders, Shock States, Hemodynamics, and
Systemic Complications – 2026 Updated Edition
Questions 1–150 (With Correct Answers & Explanations)
Section 1: Hemodynamics & Shock (Questions 1–30)
1. A patient with hypovolemic shock has a heart rate of 130 bpm and cool, clammy skin. This
compensatory mechanism is primarily mediated by:
A) Parasympathetic nervous system
B) Renin-angiotensin-aldosterone system
C) Sympathetic nervous system
D) Atrial natriuretic peptide
Correct Answer: C – Sympathetic activation increases heart rate and vasoconstriction (cool, clammy
skin) to maintain perfusion.
2. Which hemodynamic parameter is most decreased in early hypovolemic shock?
A) Systemic vascular resistance
B) Central venous pressure
C) Heart rate
D) Mean arterial pressure
Correct Answer: B – Central venous pressure (preload) drops first due to reduced intravascular
volume.
3. A patient in septic shock has warm, flushed skin and bounding pulses. This indicates:
A) High systemic vascular resistance
B) Early distributive shock with vasodilation
C) Compensated hypovolemia
D) Cardiogenic shock
Correct Answer: B – In early septic shock, cytokines cause vasodilation, leading to warm extremities
and bounding pulses.
4. The primary pathophysiologic problem in cardiogenic shock is:
A) Loss of sympathetic tone
, B) Severe hypovolemia
C) Pump failure with reduced cardiac output
D) Massive vasodilation
Correct Answer: C – Cardiogenic shock results from the heart’s inability to pump adequately, usually
after MI.
5. Which finding distinguishes cardiogenic shock from hypovolemic shock?
A) Tachycardia
B) Cool extremities
C) Elevated jugular venous pressure
D) Hypotension
Correct Answer: C – Elevated JVP indicates fluid backup (high preload) in cardiogenic shock;
hypovolemic shock has low JVP.
6. In neurogenic shock, hypotension occurs because of:
A) Decreased systemic vascular resistance
B) Decreased blood volume
C) Increased myocardial contractility
D) Increased afterload
Correct Answer: A – Loss of sympathetic tone causes unopposed vagal tone and massive vasodilation.
7. A patient with anaphylactic shock is given epinephrine. The primary desired effect is:
A) Bronchodilation only
B) Vasodilation and increased capillary permeability
C) Vasoconstriction and bronchodilation
D) Decreased heart rate
Correct Answer: C – Epinephrine is alpha-1 (vasoconstriction) and beta-2 (bronchodilation) agonist.
8. Lactic acidosis in shock states results from:
A) Increased hepatic clearance of lactate
B) Aerobic metabolism in muscles
C) Anaerobic metabolism due to tissue hypoxia
D) Respiratory alkalosis
Correct Answer: C – Poor tissue perfusion forces cells to switch to anaerobic glycolysis, producing
lactate.
9. The earliest indicator of adequate tissue perfusion in shock resuscitation is:
, A) Normal blood pressure
B) Urine output >0.5 mL/kg/hr
C) Heart rate <100 bpm
D) Warm extremities
Correct Answer: B – Urine output reflects renal perfusion and is a sensitive marker of end-organ
perfusion.
10. Mixed venous oxygen saturation (SvO2) is decreased in all types of shock except:
A) Hypovolemic
B) Cardiogenic
C) Septic (early, hyperdynamic phase)
D) Obstructive
Correct Answer: C – In early septic shock, high cardiac output and shunting may cause normal or high
SvO2.
11. Which medication is first-line for vasodilatory shock in adults?
A) Dopamine
B) Epinephrine
C) Norepinephrine
D) Phenylephrine
Correct Answer: C – Norepinephrine is guideline-recommended first-line vasopressor in septic and
vasodilatory shock.
12. Obstructive shock is most commonly caused by:
A) Myocardial infarction
B) Pulmonary embolism
C) Dehydration
D) Spinal cord injury
Correct Answer: B – Massive PE obstructs right ventricular outflow, reducing left ventricular filling.
13. Beck’s triad (hypotension, JVD, muffled heart sounds) is pathognomonic for:
A) Tension pneumothorax
B) Cardiac tamponade
C) Pulmonary embolism
D) Aortic dissection
Correct Answer: B – Pericardial fluid compresses the heart, impairing diastolic filling.
, 14. In hemorrhagic shock class III, expected blood loss is:
A) <15% of blood volume
B) 15–30%
C) 30–40%
D) >40%
Correct Answer: C – Class III (30–40% loss) causes significant tachycardia, hypotension, and oliguria.
15. The compensatory mechanism that increases preload in hypovolemic shock is:
A) Vasodilation
B) Tachycardia
C) Venous constriction
D) Bradycardia
Correct Answer: C – Venoconstriction mobilizes blood from capacitance vessels, increasing venous
return.
16. A patient in shock has a cardiac index <1.8 L/min/m² and PCWP >18 mmHg. This is consistent
with:
A) Hypovolemic shock
B) Distributive shock
C) Cardiogenic shock
D) Obstructive shock
Correct Answer: C – Low cardiac output with high filling pressures indicates pump failure.
17. In septic shock, elevated cardiac output with low systemic vascular resistance is seen in the:
A) Early or “warm” phase
B) Late or “cold” phase
C) Irreversible phase
D) Refractory phase
Correct Answer: A – Early distributive phase has vasodilation and compensatory high output.
18. Which laboratory finding suggests tissue hypoxia in shock?
A) Elevated pH
B) Elevated lactate
C) Low anion gap
D) Elevated bicarbonate
