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Neurogenic shock — RCPSC EM MCQ

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ModerateTraumaNeurogenic shockRCPSC EM

A 27-year-old skier has neck pain and bilateral hand paraesthesia after axial loading. Blood pressure is 86/48 mmHg, heart rate 48/min, skin is warm, and CT cervical spine shows C5 fracture-dislocation. What is the most likely diagnosis?

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Correct answer: C — Neurogenic shock from cervical spinal cord injury

Hypotension with bradycardia and warm skin after high cervical injury is typical of neurogenic shock. Haemorrhage usually produces tachycardia and cool clammy skin.

Reference: ATLS; Canadian spinal cord injury guidance