Critical care: first-line treatment of status epilepticus: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Critical care: first-line treatment of status epilepticus

Sample item

What is the first-line drug for status epilepticus in adults?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. A benzodiazepine such as intravenous lorazepam

Benzodiazepines such as intravenous lorazepam 4 mg, or intramuscular midazolam where there is no access, are the first-line treatment. Second-line agents include levetiracetam, phenytoin or valproate. Refractory status needs anaesthetic agents.

Option by option

  • A. Phenytoin alone

    Phenytoin is second line.

  • B. A benzodiazepine such as intravenous lorazepam (correct)

    Correct. A benzodiazepine is the first-line treatment.

  • C. Intravenous paracetamol

    Paracetamol has no anticonvulsant role.

  • D. Propofol infusion

    Propofol is used in refractory status.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, A benzodiazepine such as intravenous lorazepam. Benzodiazepines such as intravenous lorazepam 4 mg, or intramuscular midazolam where there is no access, are the first-line treatment.

Why is "Phenytoin alone" not the answer?

Phenytoin is second line.

Why is "Intravenous paracetamol" not the answer?

Paracetamol has no anticonvulsant role.

Why is "Propofol infusion" not the answer?

Propofol is used in refractory status.

What concept does this question test?

It tests Critical care: first-line treatment of status epilepticus in Anaesthesia. Second-line agents include levetiracetam, phenytoin or valproate. Refractory status needs anaesthetic agents.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Critical care: first-line treatment of status epilepticus?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.