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Sepsis — MCCQE Part 1 MCQ

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EasyAltered Level of ConsciousnessSepsisMCCQE Part 1

A 67-year-old woman with fever, confusion, respiratory rate 30/min, blood pressure 86/52 mmHg and suspected pyelonephritis presents to the emergency department. Which of the following is the most appropriate initial management?

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Correct answer: C — Sepsis bundle approach with cultures if they do not delay antibiotics, broad-spectrum antibiotics and fluid resuscitation

Hypotension, tachypnoea, confusion and infection suggest sepsis with shock risk, requiring early antibiotics and resuscitation. Cultures are useful but should not substantially delay antibiotics. Delirium treatment alone misses the underlying life-threatening infection.

Reference: Surviving Sepsis Campaign used in Canadian practice; provincial sepsis pathways