Q:

All of the following are true about neurogenic shock except:

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All of the following are true about neurogenic shock except:


  1. There is a decrease in systemic vascular resistance and an increase in venous capacitance.
  2. Tachycardia or bradycardia may be observed, along with hypotension.
  3. The use of an alpha agonist such as phenylephrine is the mainstay of treatment.
  4. Severe head injury, spinal cord injury, and high spinal anesthesia may all cause neurogenic shock.

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C. The use of an alpha agonist such as phenylephrine is the mainstay of treatment.

DISCUSSION: Neurogenic shock occurs when severe head injury, spinal cord injury, or pharmacologic sympathetic blockade leads to sympathetic denervation and loss of vasomotor tone. Both arteriolar and venous vessels dilate, causing reduced systemic vascular resistance and a great increase in venous capacitance. The patient's extremities appear warm and dry, in contrast to those of a patient in cardiogenic or hypovolemic shock. Tachycardia is frequently observed, though the classic description of neurogenic shock includes bradycardia and hypotension. Volume administration to fill the expanded intravascular compartment is the mainstay of treatment. The use of alpha-adrenergic agonist is infrequently necessary to treat neurogenic shock. 

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