Hypertensive disorders: Zuspan regimen: practice question

A OBG 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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OBG · Hypertensive disorders: Zuspan regimen

Sample item

Which of the following correctly describes the Zuspan regimen of magnesium sulphate for eclampsia?

A6 g IV loading followed by 4 g per hourB4 g IV plus 10 g IM, then 5 g IM every 4 hoursC2 g IV bolus onlyD4 g intravenous loading dose over 5 to 10 minutes, then 1 g per hour infusion

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

The answer and the reasoning

D. 4 g intravenous loading dose over 5 to 10 minutes, then 1 g per hour infusion

The Zuspan regimen is a purely intravenous schedule with a 4 g loading dose followed by 1 g per hour, whereas the Pritchard regimen combines an IV and IM loading dose with 5 g IM every 4 hours. Both are continued for 24 hours after delivery or the last convulsion. Monitoring includes respiratory rate, urine output and reflexes.

Option by option

A. 6 g IV loading followed by 4 g per hour
These doses exceed the standard and risk toxicity.
B. 4 g IV plus 10 g IM, then 5 g IM every 4 hours
This describes the Pritchard regimen.
C. 2 g IV bolus only
A single 2 g bolus is a rescue dose for a recurrent seizure, not a regimen.
D. 4 g intravenous loading dose over 5 to 10 minutes, then 1 g per hour infusion (correct)
Correct. This is the intravenous Zuspan schedule.

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.

Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, 4 g intravenous loading dose over 5 to 10 minutes, then 1 g per hour infusion. The Zuspan regimen is a purely intravenous schedule with a 4 g loading dose followed by 1 g per hour, whereas the Pritchard regimen combines an IV and IM loading dose with 5 g IM every 4 hours.

Why is "6 g IV loading followed by 4 g per hour" not the answer?

These doses exceed the standard and risk toxicity.

Why is "4 g IV plus 10 g IM, then 5 g IM every 4 hours" not the answer?

This describes the Pritchard regimen.

Why is "2 g IV bolus only" not the answer?

A single 2 g bolus is a rescue dose for a recurrent seizure, not a regimen.

What concept does this question test?

It tests Hypertensive disorders: Zuspan regimen in OBG. Both are continued for 24 hours after delivery or the last convulsion. Monitoring includes respiratory rate, urine output and reflexes.

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 Hypertensive disorders: Zuspan regimen?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG 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.