🏥 USMLE Exam Prep

A 68-year-old woman presents to the emergency department with signs of septic shock, including hypotension (BP 80/50 mmHg), tachycardia (HR 120/min), and altered mental status. After initial fluid resuscitation with 3 liters of normal saline, her blood pressure remains 85/55 mmHg. Her urine output is minimal. Which of the following is the most appropriate next step in management?

A Administer additional intravenous fluids rapidly
B Initiate norepinephrine infusion
C Order a computed tomography (CT) scan of the abdomen
D Start dobutamine infusion

✓ Correct Answer: Option B

For patients in septic shock who remain hypotensive despite adequate fluid resuscitation, vasopressors are indicated to maintain mean arterial pressure. Norepinephrine is the first-line vasopressor in septic shock due to its potent alpha-adrenergic effects, increasing vascular tone.

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