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Urosepsis — USMLE Step 3 MCQ

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HardEmergency MedicineUrosepsisUSMLE Step 3

A 43-year-old woman has fever, flank pain, hypotension, and confusion. Urinalysis shows pyuria and bacteria. Lactate is 4.5 mmol/L. Blood cultures are drawn. Which of the following is the most appropriate next step in management?

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Correct answer: D — Begin broad-spectrum antibiotics and intravenous crystalloid resuscitation

Sepsis with suspected urinary source requires prompt antibiotics and hemodynamic resuscitation after cultures when this does not delay treatment.

Reference: Surviving Sepsis Campaign; IDSA UTI guidance