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Septic Shock — RACP Adult Medicine MCQ

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EasyInfectious DiseasesSeptic ShockRACP Adult Medicine

A 50-year-old woman presents with BP 70/30 mmHg, HR 125 bpm, temperature 39.8°C, warm peripheries with bounding pulses, and lactate 7.2 mmol/L. She has right flank tenderness and pyuria. Blood cultures grow E. coli. What is the most likely type of shock?

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Correct answer: B — Distributive (septic) shock

Hypotension with warm peripheries (vasodilatory), bounding pulses, tachycardia, fever, and confirmed bacteraemia with a urinary source is septic shock. Septic shock = sepsis + vasopressor requirement to maintain MAP ≥65 mmHg + lactate >2 mmol/L despite adequate fluid resuscitation. Surviving Sepsis 2021: 30 mL/kg crystalloid within 3 hours, blood cultures before antibiotics, antibiotics within 1 hour.

Reference: Surviving Sepsis Campaign 2021; eTG Antibiotic 2025