Trauma: neurogenic shock: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Trauma: neurogenic shock

Sample item

A 25-year-old man falls from a height and has a cervical spinal cord injury. His blood pressure is 80/50 mmHg, heart rate 48 per minute, and his skin is warm and dry. There is no external bleeding and FAST is negative. What is the most likely cause of the shock?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Neurogenic shock from loss of sympathetic tone

High spinal cord injury interrupts sympathetic outflow, causing vasodilatation with hypotension and unopposed vagal bradycardia, with warm peripheries. Haemorrhage must still be excluded first. Treatment is judicious fluid resuscitation followed by vasopressors, with atropine for symptomatic bradycardia.

Option by option

  • A. Tension pneumothorax

    Tension pneumothorax causes tachycardia, tracheal shift and absent breath sounds.

  • B. Neurogenic shock from loss of sympathetic tone (correct)

    Correct. Hypotension with bradycardia and warm skin indicates neurogenic shock.

  • C. Haemorrhagic shock

    Haemorrhage produces tachycardia and cool, clammy skin.

  • D. Cardiac tamponade

    Tamponade shows raised neck veins and fluid on FAST, which is negative here.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Neurogenic shock from loss of sympathetic tone. High spinal cord injury interrupts sympathetic outflow, causing vasodilatation with hypotension and unopposed vagal bradycardia, with warm peripheries.

Why is "Tension pneumothorax" not the answer?

Tension pneumothorax causes tachycardia, tracheal shift and absent breath sounds.

Why is "Haemorrhagic shock" not the answer?

Haemorrhage produces tachycardia and cool, clammy skin.

Why is "Cardiac tamponade" not the answer?

Tamponade shows raised neck veins and fluid on FAST, which is negative here.

What concept does this question test?

It tests Trauma: neurogenic shock in General Surgery. Haemorrhage must still be excluded first. Treatment is judicious fluid resuscitation followed by vasopressors, with atropine for symptomatic bradycardia.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Trauma: neurogenic shock?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.