A 28-Year-Old Man with a History of Spinal Cord Injury

question 270

Multiple Choice

A 28-year-old man with a history of spinal cord injury comes to the emergency department due to headache, restlessness, and excessive sweating for the past several hours.  A year ago, the patient was involved in a motor vehicle collision that caused a C6 spinal cord injury, leading to paraplegia and neurogenic bladder.  He has no other medical concerns.  Temperature is 36 C (96.8 F) , blood pressure is 170/100 mm Hg, and pulse is 52/min.  Physical examination shows facial flushing and excessive perspiration.  The lungs are clear to auscultation and heart sounds are normal.  The abdomen is soft with a mass palpable in the lower abdomen.  A suprapubic catheter is present.  Neurologic examination demonstrates absence of pain and temperature sensation below the nipples and paraplegic and spastic lower extremities, unchanged from previous examination.  Further evaluation reveals occlusion of the urinary catheter and urinary retention.  The urinary catheter is changed, which leads to rapid improvement in the patient's symptoms and hypertension.  Which of the following best explains the observed findings in this patient?

• A)Autonomic dysreflexia
• B)Carotid sinus hypersensitivity
• C)Catecholamine-secreting tumor
• D)Peripheral autonomic neuropathy
• E)Renovascular hypertension
• F)Spinal shock state

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Definitions:

Personality

The combination of characteristics or qualities that form an individual's distinctive character.

Perceiving Work

Refers to an individual's understanding and interpretation of their work roles and responsibilities.

Flexibility and Spontaneity

The ability to adapt quickly to changing circumstances and make decisions impulsively when necessary.

Acting with Order

The practice of performing tasks and activities in a structured, organized manner to achieve goals efficiently.