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Severe community-acquired pneumonia with septic shock — ABEM Board MCQ

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HardPulmonary emergenciesSevere community-acquired pneumonia with septic shockABEM Board

A 39-year-old woman presents as triage level 2 with fever, cough, pleuritic pain, and dyspnea. CT from urgent care shows multilobar pneumonia; BP is 88/54 mm Hg after 30 mL/kg crystalloid, lactate is 4.8 mmol/L, and oxygen saturation is 91% on high-flow nasal cannula. 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: E — Begin broad-spectrum antibiotics and norepinephrine with ICU admission

Septic shock from pneumonia requires early antibiotics, source-directed care, vasopressors after fluid resuscitation, and critical care disposition.

Reference: Surviving Sepsis Campaign; IDSA/ATS CAP guidance