American Board of Surgery Qualifying Exam (ABS QE) Practice Test

In the context of shock types, what is a hallmark of adrenal shock?

1. Increased CO

2. Decreased CVP

3. Decreased blood volume

4. Increased SVR

The correct answer is: Decreased blood volume

Adrenal shock, often related to adrenal insufficiency or adrenal crisis, is characterized by a decrease in corticosteroid hormone levels. This lack of corticosteroids directly impacts the body's ability to maintain blood volume and vascular tone, ultimately leading to a deficit in circulating blood volume. In adrenal shock, the body does not retain sodium and water adequately due to insufficient aldosterone, a hormone critical for fluid retention. This results in significant fluid losses and a decreased effective circulating volume, contributing to hypotension and inadequate tissue perfusion. This pathophysiological mechanism underscores why decreased blood volume is a hallmark feature of adrenal shock. In contrast, conditions such as septic shock or cardiogenic shock might present with increased cardiac output or specific alterations in central venous pressure (CVP) and systemic vascular resistance (SVR), but these are not characteristic of adrenal shock. Thus, the hallmark of adrenal shock is the significant decrease in blood volume, leading to its distinct clinical features.