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Question 400
Pathology → General
Classification
Question
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A patient remains in severe circulatory shock despite compensatory responses. Tissue perfusion progressively deteriorates, metabolic abnormalities become self-perpetuating and widespread organ injury develops. Which stage of shock is reached when recovery is no longer possible despite correction of the initiating haemodynamic disturbance?
Question Stem
Select the single best answer.
Options
A
Initial compensated stage
B
Early reversible stage
C
Transient hyperdynamic stage
D
Irreversible decompensated stage
E
Local inflammatory stage
Explanation
Shock progresses from an initial reversible or compensated phase through a progressive decompensated phase and ultimately to an irreversible stage. In the irreversible stage, severe cellular and organ injury has progressed to the point that haemodynamic correction can no longer restore survival.
Option Validity
A) The compensated stage remains reversible because homeostatic mechanisms are still capable of maintaining vital-organ perfusion.
B) An early reversible stage, by definition, has not yet reached the point of irreversible injury.
C) A hyperdynamic circulation may occur during septic shock but does not itself define the terminal irreversible stage of shock.
E) Local inflammation is not one of the defined stages in the progression of circulatory shock.
Further Reading
Saxena R. Textbook for MRCOG-1. Chapter 5: Pathology. General Pathology, pp.161–175.