Neurology: status epilepticus: practice question

A Pediatrics 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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Pediatrics · Neurology: status epilepticus

Sample item

A 4-year-old has a generalised seizure continuing for 10 minutes. IV access is not yet available. Which is the best first-line drug?

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

The answer and the reasoning

C. Intranasal or buccal midazolam or rectal diazepam

Benzodiazepines are first line, via the intranasal, buccal or rectal route when there is no IV access, or IV lorazepam or diazepam if available. If seizures persist, a second-line drug such as IV phenytoin, levetiracetam or valproate is given. Blood glucose is checked.

Option by option

  • A. Intramuscular phenytoin

    IM phenytoin is erratically absorbed and is not used.

  • B. Oral phenobarbitone

    Oral drugs are unsafe in an actively seizing child.

  • C. Intranasal or buccal midazolam or rectal diazepam (correct)

    Correct. A benzodiazepine by an accessible route.

  • D. Oral carbamazepine

    Carbamazepine has no parenteral form for emergency use.

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.

More Pediatrics questions

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is C, Intranasal or buccal midazolam or rectal diazepam. Benzodiazepines are first line, via the intranasal, buccal or rectal route when there is no IV access, or IV lorazepam or diazepam if available.

Why is "Intramuscular phenytoin" not the answer?

IM phenytoin is erratically absorbed and is not used.

Why is "Oral phenobarbitone" not the answer?

Oral drugs are unsafe in an actively seizing child.

Why is "Oral carbamazepine" not the answer?

Carbamazepine has no parenteral form for emergency use.

What concept does this question test?

It tests Neurology: status epilepticus in Pediatrics. If seizures persist, a second-line drug such as IV phenytoin, levetiracetam or valproate is given. Blood glucose is checked.

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 Neurology: status epilepticus?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.