Facharzt FMH Kinder- Und Jugendmedizin Practice Questions - Facharzt FMH Für Kinder- Und Jugendmedizin Spécialiste FMH En Pédiatrie Exam

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A 3-year-old child presents to the emergency department with high fever, lethargy, cool extremities with mottled skin, delayed capillary refill time of 4 seconds, heart rate of 175 beats/min, and blood pressure of 72/44 mmHg (cold septic shock). Peripheral IV access has been established. In accordance with Pediatric Advanced Life Support (PALS) and international pediatric sepsis guidelines, what is the most appropriate initial resuscitation strategy?

Immediate rapid IV infusion of 50 mL/kg of 0.45% sodium chloride with 5% dextrose over 10 minutes Immediate initiation of an intravenous sodium bicarbonate infusion to correct metabolic acidosis Rapid administration of a 10 to 20 mL/kg bolus of balanced isotonic crystalloid over 10 to 20 minutes with frequent cardiopulmonary reassessment High-dose intravenous loop diuretic therapy to prevent non-cardiogenic pulmonary edema

Correct Answer:

Rapid administration of a 10 to 20 mL/kg bolus of balanced isotonic crystalloid over 10 to 20 minutes with frequent cardiopulmonary reassessment

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