Shock Management

A 42-year-old woman with acute coronary syndrome complicated by acute anterior wall myocardial infarction undergoes primary percutaneous coronary intervention. Post-PCI angiography shows TIMI 3 flow. However, 2 hours later, she develops hypotension (BP 82/48 mmHg), elevated JVP, clear lung fields on auscultation, and a new holosystolic murmur at the apex. Echocardiography confirms acute mitral regurgitation secondary to papillary muscle rupture. What is the most appropriate immediate next step?

A 52-year-old man with acute myocardial infarction presents with hypotension (SBP 85 mmHg), elevated JVP, and clear lung fields. A second patient with septic shock from pneumonia presents with hypotension (SBP 80 mmHg), normal JVP, and pulmonary crackles. Which single feature best distinguishes cardiogenic shock from septic shock?

A 38-year-old woman with severe burns (40% TBSA) is in hypovolemic shock with hypotension and oliguria. A 45-year-old man with acute pancreatitis is in distributive shock with hypotension but normal urine output. Which finding best distinguishes hypovolemic shock from distributive (septic/anaphylactic) shock?

A 58-year-old man with a history of diabetes mellitus type 2 presents to the emergency department with a 6-hour history of fever (39.5°C), hypotension (BP 88/52 mmHg), tachycardia (HR 118/min), and altered mental status. Blood cultures have been drawn. Lactate is 4.2 mmol/L. What is the most appropriate immediate next step in management?

A 58-year-old man with septic shock secondary to pneumonia is being managed in the ICU. He receives fluid resuscitation, broad-spectrum antibiotics, and vasopressors. Regarding the pathophysiology and management of septic shock, all of the following are correct EXCEPT: