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Free practice question 19 of 20 · Trauma

Shock: a free MRCS Part A question

An original single best answer question in the style of the MRCS Part A paper, with the answer and a referenced explanation. Pick an answer to reveal it, then rate how sure you were.

19Trauma·Shock
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A 78-year-old man taking bisoprolol for hypertension is struck by a car. His pulse is 78/min and blood pressure 116/70 mmHg; his usual systolic pressure is about 165 mmHg. His peripheries are cool and his lactate is 4.8 mmol/L.

Which best explains his presentation?

How sure are you?

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