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Sepsis initial management — USMLE Step 3 MCQ

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ModerateEmergency MedicineSepsis initial managementUSMLE Step 3

A 67-year-old woman presents with fever, confusion, cough, and hypotension. Blood pressure is 82/48 mm Hg, heart rate is 122/min, respiratory rate is 28/min, and oxygen saturation is 91%. Lactate is 4.2 mmol/L and chest x-ray shows right lower lobe infiltrate. Which of the following is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Give broad-spectrum antibiotics and 30 mL/kg crystalloid promptly

Septic shock or sepsis-induced hypoperfusion requires prompt antibiotics, cultures when feasible without delay, and initial crystalloid resuscitation.

Reference: Surviving Sepsis Campaign Guidelines