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Status epilepticus (adult) — UKMLA MCQ

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HardNeurologyStatus epilepticus (adult)UKMLAMRCP Part 1MRCEM SBAPARAPSA

An adult has a generalised convulsion lasting 6 minutes in the emergency department. Airway support is under way, capillary glucose is normal, IV access and resuscitation facilities are available, and no benzodiazepine has yet been given. Which first drug dose should the PA prepare while calling senior emergency support?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Lorazepam 4 mg intravenously

B is correct. Convulsive status epilepticus is treated from 5 minutes; with IV access, adult guidance uses lorazepam 4 mg IV, with respiratory monitoring and a second benzodiazepine dose only if seizure activity persists after 5–10 minutes. A is below the adult IV diazepam alternative dose. C and E are second-line drugs after two adequate benzodiazepine doses. D is an alternative route when IV access is unavailable, not the preferred choice here.

Reference: NICE NG217: treating status epilepticus: https://www.nice.org.uk/guidance/ng217/chapter/7-Treating-status-epilepticus-repeated-or-cluster-seizures-and-prolonged-seizures NHS Borders: in-hospital treatment of convulsive status epilepticus: https://www.rightdecisions.scot.nhs.uk/nhs-borders-clinical-guidelines/drugs-and-therapeutics/in-hospital-drug-treatment-of-convulsive-status-epilepticus-in-adults/ GMC: PA registration assessment content map: https://www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes/pa-and-aa-prequalification-education-framework/pa-registration-assessment-content-map