55. A young girl presents to you with a sore throat and fever. You diagnose her

Question

55. A young girl presents to you with a sore throat and fever. You diagnose her with pharyngitis caused by group A hemolytic streptococcus. She is given an IM injection of penicillin. Approximately 5 minutes later, she if found to be in respiratory distress and audibly wheezing Her skin is mottled and cool, she is tachycardic, and her blood pressure has fallen to 70/20 mmHg. a. What is your diagnosis of the patient after the IM injection of penicillin? b. What is your recommendation for treatment of the patient now? What effect do you expect on the patient's vascular system after administration of the drug you recommend? Which adrenoceptor primarily will be involved in this effect? c. of the drug you recommend? Which adrenoceptor primarily will be involved in this effect?

Explanation / Answer

Answer:

a) After the patient was treated with penicillin, he/she went into septic shock. This might happen due to failure of the antibiotic to work againts the bacteria because of which the bacteria spread into blood and caused bacteremia which became the cause for septic shock. Also the immediate symptoms like low blood pressure of 70/20 mmHg, tachycardic( high heart rate) and skin mollting ( blood clots because of which rash like purple veins appear) all points towards septic shock.

b) Treatment includes:

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