SBA — Single Best Answer · Review
Question 411
Pathology → General
Classification
Question
SSBAQuestion Header
A patient with established septic shock develops severe respiratory dysfunction. Which combination best reflects the pulmonary abnormalities associated with septic shock?
Question Stem
Select the single best answer.
Options
A
Reduced pulmonary vascular resistance with improved oxygenation and absence of oedema
B
Pulmonary capillary injury with oedema, increased pulmonary vascular resistance and impaired oxygenation
C
Isolated bronchoconstriction without vascular or alveolar injury
D
Increased oxygenation due to complete elimination of arteriovenous shunting
E
Pulmonary vasodilatation without pneumonitis, atelectasis or oedema
Explanation
The pulmonary consequences of septic shock include pulmonary capillary injury, oedema, increased pulmonary vascular resistance and impaired oxygenation. Atelectasis, arteriovenous shunting and pneumonitis may further compromise gas exchange.
Option Validity
A) Septic shock may increase pulmonary vascular resistance and impair rather than improve oxygenation.
C) The pulmonary injury is not confined to isolated bronchoconstriction; capillary and parenchymal abnormalities are important.
D) Arteriovenous shunting contributes to impaired oxygenation rather than being completely eliminated.
E) Oedema, pneumonitis and atelectasis are among the pulmonary abnormalities described.
Further Reading
Saxena R. Textbook for MRCOG-1. Chapter 5: Pathology. General Pathology, pp.161–175.