🏥 USMLE Exam Prep

A 72-year-old female admitted for pneumonia develops septic shock. Despite adequate fluid resuscitation and broad-spectrum antibiotics, she remains hypotensive (MAP < 65 mmHg) requiring high-dose norepinephrine. Her blood glucose is 180 mg/dL. What is the next most appropriate pharmacological intervention?

A Administer vasopressin
B Initiate continuous insulin infusion
C Start a phenylephrine infusion
D Give an additional fluid bolus

✓ Correct Answer: Option A

If septic shock persists despite adequate fluid resuscitation and high-dose norepinephrine, vasopressin (a non-adrenergic vasopressor) is recommended as a second vasopressor agent. It acts via V1 receptors to cause vasoconstriction.

Related USMLE Exam Prep Questions