A patient with a severe bacterial infection develops systemic inflammatory response syndrome (SIRS) and then progresses to septic shock. The key pathophysiological event in septic shock is:

  • Massive vasodilation and increased capillary permeability due to inflammatory mediators.
  • Direct myocardial tissue damage.
  • Pulmonary embolism.
  • Hyperglycemia due to insulin resistance.
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