Hypertensive disorders: magnesium sulphate 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.

Try it

OBG · Hypertensive disorders: magnesium sulphate regimen

Sample item

According to the Indian national (Pritchard) regimen for severe pre-eclampsia, what is the loading dose of magnesium sulphate?

A1 g IV onlyB4 g IV of 20 per cent solution plus 10 g IM (5 g in each buttock)C20 g IV bolusD5 g IM single buttock only

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

The answer and the reasoning

B. 4 g IV of 20 per cent solution plus 10 g IM (5 g in each buttock)

The Pritchard regimen gives a 4 g IV loading dose slowly over 5 to 10 minutes and 10 g deep IM (5 g in each buttock) with 1 mL of 2 per cent lignocaine. Maintenance is 5 g IM every 4 hours alternating buttocks, continued for 24 hours after delivery or last seizure.

Option by option

A. 1 g IV only
1 g IV is subtherapeutic.
B. 4 g IV of 20 per cent solution plus 10 g IM (5 g in each buttock) (correct)
Correct. This is the standard Pritchard loading dose.
C. 20 g IV bolus
20 g IV bolus would be toxic.
D. 5 g IM single buttock only
5 g IM alone would not give an adequate loading dose.

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 B, 4 g IV of 20 per cent solution plus 10 g IM (5 g in each buttock). The Pritchard regimen gives a 4 g IV loading dose slowly over 5 to 10 minutes and 10 g deep IM (5 g in each buttock) with 1 mL of 2 per cent lignocaine.

Why is "1 g IV only" not the answer?

1 g IV is subtherapeutic.

Why is "20 g IV bolus" not the answer?

20 g IV bolus would be toxic.

Why is "5 g IM single buttock only" not the answer?

5 g IM alone would not give an adequate loading dose.

What concept does this question test?

It tests Hypertensive disorders: magnesium sulphate regimen in OBG. Maintenance is 5 g IM every 4 hours alternating buttocks, continued for 24 hours after delivery or last seizure.

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: magnesium sulphate 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.