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6430 Microbiology

In a patient with massive thromboembolism with hypotension after a fluid bolus of 1 L, the patient’s blood pressure remains low at 88/50 mmHg. Echocardiogram demonstrates hypokinesis of the right ventricle. What is the next best step in the management of this patient?

Atreatment with dopamine and recombinant tissue plasminogen activator, 100 mg IV
BContinue IV fluids at 500 mL/hr for a total of 4 L of fluid resuscitation
CRefer for inferior vena cava filter placement and continue current management
DRefer for surgical embolectomy
Microbiology
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