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ASD – CMA genetic testing — RACP Paediatrics MCQ

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HardNeurologyASD – CMA genetic testingRACP Paediatrics

A 9-year-old continues generalised convulsive activity on emergency-department arrival. Paramedics gave two appropriate buccal midazolam doses, the second four minutes ago. Glucose and oxygenation are satisfactory. What should happen next?

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Correct answer: A — Proceed to second-line antiseizure treatment under continuous monitoring

Explanation lettering: D = shown as A · E = shown as B · A = shown as C · B = shown as D · C = shown as E

D is correct. Prehospital benzodiazepine doses count toward the usual two-dose ceiling; further benzodiazepine increases respiratory-depression risk, so ongoing convulsive status proceeds to second-line therapy with resuscitation and senior support. A exceeds that ceiling. B incorrectly disregards prehospital treatment. C and E may be indicated after stabilisation for selected causes but must not delay seizure termination.

Reference: RCH Melbourne, Seizures: acute management: https://www.rch.org.au/clinicalguide/guideline_index/Seizures_-_acute_management/