This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Trauma, Subject name: Surgery
[{'content': 'The response to shock includes which of the following metabolic effects? \nSelect and explain. \nA. Increase in sodium and water excretion, B. Increase in renal perfusion, C. Decrease in cortisol levels, D. Hyperkalemia', 'role': 'user'}, {'content': 'Answer: D \nExplanation: The biochemical changes associated with shock result from tissue hypoperfusion, endocrine response to stress, and specific organ system failure. During shock, the sympathetic nervous system and adrenal medulla are stimulated to release catecholamines. Renin, angiotensin, antidiuretic hormone, adrenocorticotropin, and cortisol levels increase. Resultant changes include sodium and water retention and an increase in potassium excretion, protein catabolism, and gluconeogenesis. Potassium levels rise as a result of increased tissue release, anaerobic metabolism, and decreased renal perfusion. If renal function is maintained, potassium excretion is high and normal plasma potassium levels are restored.', 'role': 'assistant'}]