Hypertensive disorders: recurrent seizure on magnesium: 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: recurrent seizure on magnesium

Sample item

A woman on maintenance magnesium sulphate for eclampsia has a second convulsion. Reflexes are present and respiration is normal. What is the next step?

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

The answer and the reasoning

D. Give a further intravenous bolus of magnesium sulphate

Magnesium sulphate remains the drug of choice. A recurrent fit with preserved reflexes and normal respiration is treated with an additional bolus, while airway and oxygen are secured and the cause is reviewed. Other anticonvulsants are for refractory cases.

Option by option

  • A. Give calcium gluconate

    Calcium gluconate reverses toxicity and would worsen seizure control.

  • B. Replace magnesium with intravenous phenytoin

    Phenytoin is inferior to magnesium and is not a replacement in this setting.

  • C. Give intravenous diazepam as the primary agent

    Diazepam is an alternative only when magnesium is unavailable or has failed.

  • D. Give a further intravenous bolus of magnesium sulphate (correct)

    Correct. An additional bolus raises the level and controls recurrence.

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 OBG question

What is the answer to this OBG question?

The best answer is D, Give a further intravenous bolus of magnesium sulphate. Magnesium sulphate remains the drug of choice.

Why is "Give calcium gluconate" not the answer?

Calcium gluconate reverses toxicity and would worsen seizure control.

Why is "Replace magnesium with intravenous phenytoin" not the answer?

Phenytoin is inferior to magnesium and is not a replacement in this setting.

Why is "Give intravenous diazepam as the primary agent" not the answer?

Diazepam is an alternative only when magnesium is unavailable or has failed.

What concept does this question test?

It tests Hypertensive disorders: recurrent seizure on magnesium in OBG. A recurrent fit with preserved reflexes and normal respiration is treated with an additional bolus, while airway and oxygen are secured and the cause is reviewed. Other anticonvulsants are for refractory cases.

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: recurrent seizure on magnesium?

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.