Cardiovascular · UKMLA & AKT
Hypovolaemic shock
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise hypovolaemic shock — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Tachycardia - earliest sign; sympathetic drive compensates for falling stroke volume
- Hypotension - systolic BP <100 mmHg; a late sign in young/fit patients
- Cool, pale, clammy peripheries - peripheral vasoconstriction redirects blood to vital organs
- Prolonged capillary refill (>2 seconds) - reduced peripheral perfusion pressure
- Oliguria (<0.5 ml/kg/hr) - renal vasoconstriction and RAAS activation
- Altered consciousness - confusion/agitation indicates cerebral hypoperfusion (Class III/IV)
- Raised respiratory rate (>20/min) - compensatory response to metabolic acidosis
A young, fit patient may maintain a near-normal BP until 30% of circulating volume is lost - do not be falsely reassured by a preserved blood pressure.
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