skip to main content

Septic shock — RCPSC IM MCQ

Instant feedback + full explanation. One question, done properly.

ModerateCritical CareSeptic shockRCPSC IM

A 63-year-old man with cirrhosis from metabolic dysfunction-associated steatohepatitis is admitted to a Winnipeg ICU with septic shock from spontaneous bacterial peritonitis. After 30 mL/kg crystalloid and ceftriaxone, mean arterial pressure remains 58 mm Hg and lactate is 5.4 mmol/L. Bedside ultrasound shows no tamponade and a collapsible inferior vena cava is no longer present. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: A — Start norepinephrine and continue source-directed care

Persistent hypotension after adequate initial fluid resuscitation in septic shock requires norepinephrine as first-line vasopressor, alongside antibiotics and source control.

Reference: Surviving Sepsis Campaign; Canadian critical care practice