Trauma and burns: spinal 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 and burns: spinal shock

Sample item

A man with a cervical spine fracture has flaccid paralysis, absent reflexes and hypotension. Which finding marks the end of spinal shock?

AReturn of the bulbocavernosus reflexBReturn of voluntary movement in all limbsCDisappearance of priapismDNormalisation of blood pressure

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

The answer and the reasoning

A. Return of the bulbocavernosus reflex

Spinal shock ends when reflex activity returns below the lesion, and the earliest sign is the return of the bulbocavernosus reflex. It is the reflex, not voluntary power, that returns first.

Option by option

A. Return of the bulbocavernosus reflex (correct)
Correct. The bulbocavernosus reflex is the first to recover.
B. Return of voluntary movement in all limbs
Voluntary movement depends on the extent of the cord injury.
C. Disappearance of priapism
Priapism is not a marker for the end of spinal shock.
D. Normalisation of blood pressure
Hypotension from loss of sympathetic tone is neurogenic shock, which behaves separately.

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.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Return of the bulbocavernosus reflex. Spinal shock ends when reflex activity returns below the lesion, and the earliest sign is the return of the bulbocavernosus reflex.

Why is "Return of voluntary movement in all limbs" not the answer?

Voluntary movement depends on the extent of the cord injury.

Why is "Disappearance of priapism" not the answer?

Priapism is not a marker for the end of spinal shock.

Why is "Normalisation of blood pressure" not the answer?

Hypotension from loss of sympathetic tone is neurogenic shock, which behaves separately.

What concept does this question test?

It tests Trauma and burns: spinal shock in General Surgery. It is the reflex, not voluntary power, that returns first.

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 and burns: spinal 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.