A 55-year-old man presents with fever, hypotension (82/50 mm Hg), tachycardia 115/min, and lactate 4.8 mmol/L after suspected pyelonephritis. After ob...

Question

A 55-year-old man presents with fever, hypotension (82/50 mm Hg), tachycardia 115/min, and lactate 4.8 mmol/L after suspected pyelonephritis. After obtaining blood cultures and starting broad-spectrum antibiotics, what is the next best step?

Accepted Answer

Administer at least 30 mL/kg IV crystalloid within the first 3 hours.

Answer

Start vasopressin as the first-line vasopressor.

Answer

Give a single 500 mL normal saline bolus and reassess later.

Answer

Administer hydrocortisone immediately.

Answer

Infuse 500 mL 5% albumin instead of crystalloids.

Septic Shock — MRCEM SBA MCQ

A 55-year-old man presents with fever, hypotension (82/50 mm Hg), tachycardia 115/min, and lactate 4.8 mmol/L after suspected pyelonephritis. After obtaining blood cultures and starting broad-spectrum antibiotics, what is the next best step?