🏥 USMLE Exam Prep

A 60-year-old man presents with fever, chills, and altered mental status. His vital signs are BP 80/50 mmHg, HR 120 bpm, RR 24 bpm, Temp 102.5°F (39.2°C). His lactate level is 4.5 mmol/L. After initial fluid resuscitation, his blood pressure remains low. Which of the following is the most appropriate next step in management?

A Initiate broad-spectrum antibiotics
B Administer intravenous hydrocortisone
C Start norepinephrine infusion
D Obtain a CT scan of the abdomen

✓ Correct Answer: Option C

This patient has septic shock refractory to fluid resuscitation. Norepinephrine is the first-line vasopressor to increase mean arterial pressure in septic shock. Broad-spectrum antibiotics are given *with* initial resuscitation, not after fluids if BP is still low.

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