Step 2

Pulmonary 8

A 53-year-old woman with a past medical history of hypertension and depression is admitted to the hospital for management of acute diverticulitis with abscess. She is taken to the operating room and undergoes sigmoidoscopy, during which she lost approximately one liter of blood. She is brought to the post anesthesia care unit (PACU) for monitoring post-operatively and is successfully extubated. During monitoring in the PACU, she is suddenly found to be tachypneic and tachycardic with a fever of 39.7°C (103.5°F). Other vitals signs include blood pressure 155/84 mmHg, heart rate 99 beats/min, and respirations 28/min with oxygen saturation 99% on 2 liters of oxygen. An electrocardiogram (ECG) was obtained which shows sinus tachycardia with no other acute changes. On physical examination, the patient appears to have generalized muscle contractures. Electrolytes, creatine kinase, and an ABG (arterial blood gas) are immediately obtained and results are pending.

Which of the following is the most appropriate next step in management?

  • A) Administer calcium chloride and wait for laboratory results
  • B) Cyproheptadine
  • C) Dantrolene
  • D) Diltiazem
  • E) Treatment of fever with acetaminophen


Yunjia Shen


Dr. Raj Dasgupta