Emergency and critical care: neurogenic shock: practice question

A General Medicine 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 Medicine · Emergency and critical care: neurogenic shock

Sample item

A 25-year-old man has a cervical spine fracture after a diving accident. His blood pressure is 80/50 mmHg and heart rate is 48 per minute, with warm dry extremities. What is the likely cause of the shock?

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

The answer and the reasoning

B. Loss of sympathetic tone from cord injury

A high spinal injury interrupts sympathetic outflow, producing vasodilatation and unopposed vagal bradycardia. The skin is warm, unlike in haemorrhagic shock where tachycardia and cold extremities are typical. Treatment is fluids and vasopressors.

Option by option

  • A. Massive intra-abdominal haemorrhage

    Haemorrhage usually causes tachycardia and cold peripheries.

  • B. Loss of sympathetic tone from cord injury (correct)

    Correct. Interrupted sympathetic outflow causes hypotension with bradycardia.

  • C. Cardiac tamponade

    Tamponade gives distended neck veins and muffled heart sounds with tachycardia.

  • D. Tension pneumothorax

    Tension pneumothorax causes tachycardia, respiratory distress and tracheal shift.

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.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Loss of sympathetic tone from cord injury. A high spinal injury interrupts sympathetic outflow, producing vasodilatation and unopposed vagal bradycardia.

Why is "Massive intra-abdominal haemorrhage" not the answer?

Haemorrhage usually causes tachycardia and cold peripheries.

Why is "Cardiac tamponade" not the answer?

Tamponade gives distended neck veins and muffled heart sounds with tachycardia.

Why is "Tension pneumothorax" not the answer?

Tension pneumothorax causes tachycardia, respiratory distress and tracheal shift.

What concept does this question test?

It tests Emergency and critical care: neurogenic shock in General Medicine. The skin is warm, unlike in haemorrhagic shock where tachycardia and cold extremities are typical. Treatment is fluids and vasopressors.

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 Emergency and critical care: neurogenic shock?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.