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Septic shock from urinary source — SCE Acute Medicine MCQ

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EasySepsis and Infectious EmergenciesSeptic shock from urinary sourceSCE Acute Medicine

A 74-year-old woman is assessed on the acute medical unit. She has rigors, dysuria and confusion. Blood pressure is 82/48 mmHg despite initial fluids and lactate is 4.1 mmol/L. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate next step in management?

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Correct answer: B — Give broad-spectrum intravenous antibiotics within one hour

Give broad-spectrum intravenous antibiotics within one hour is the best answer because high-risk suspected sepsis with shock physiology requires antibiotics within one hour plus source control and monitoring. Give intravenous calcium gluconate immediately is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Sepsis treatment is time-critical, but cultures should be taken first when this does not delay treatment.

Reference: NICE NG253