Typical exam stem
A patient with pneumonia becomes hypotensive, confused and oliguric. How would you assess and manage possible septic shock?
Active exam mode
Plan the case before reading, then mark sections, reveal pearls and self-rate the viva.
1. Sixty-second answer plan
1:00Before reading the notes, say or write your assessment, investigations and management structure.
2. Section checklist
Mark each section only after you can explain its main decision points without reading.
3. Exam-pearl flashcards
Try to predict the pearl before revealing it.
4. Viva drill
Answer aloud before rating yourself. Anything marked “review” stays visible in your progress.
How do sepsis and septic shock differ?
Progress is saved on this device. Use “Reset session” when you want a fresh attempt.
Recognise organ dysfunction, not fever alone
Sepsis is life-threatening organ dysfunction caused by a dysregulated response to infection. The exam answer should identify the source of infection, show evidence of organ dysfunction and begin resuscitation immediately. Fever may be absent, especially in older or immunocompromised patients.
Immediate assessment
- Airway and oxygenation, respiratory rate and work of breathing.
- Blood pressure, pulse, perfusion, mental state and urine output.
- Serum lactate when available as a marker of illness severity and perfusion abnormality.
- Blood cultures before antibiotics when this does not meaningfully delay antimicrobial treatment.
- Source-directed samples and imaging according to the suspected infection.
Early treatment
Give appropriate empiric antimicrobials promptly, tailored to the likely source, local resistance patterns, prior colonisation and immune status. Give intravenous crystalloid for hypoperfusion while repeatedly assessing response and avoiding fluid overload. Persistent hypotension despite appropriate fluid resuscitation requires vasopressor support, with norepinephrine commonly used as first-line therapy.
Source control is fundamental. Drain infected collections, remove infected devices or obtain surgical control when required rather than relying on antibiotics alone.
Guideline source for further reading
This page is an original exam-revision summary. For clinical decisions, use current local protocols and the primary guidance below.