The stem gives no fever, bleeding, abdominal findings or operation type. Cold extremities with tachycardia and hypotension fit both late septic shock (cold, pale skin) and hypovolemic shock (cold, clammy extremities). The post-operative day 5 timing is the intended clue for an anastomotic leak with sepsis (D). The sources do not give leak timing, and the same recalled question (D-592) is keyed to hypovolemic shock (B). Neurogenic shock (warm skin, bradycardia) does not fit.