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Status epilepticus — MCCQE Part 1 MCQ

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HardSeizuresStatus epilepticusMCCQE Part 1

A 44-year-old has a generalised tonic-clonic seizure lasting 7 minutes in the emergency department and glucose is normal. Which of the following is the most appropriate next step?

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Correct answer: CGive a benzodiazepine immediately followed by longer-acting antiseizure therapy if needed

Give a benzodiazepine immediately followed by longer-acting antiseizure therapy if needed is the single best answer because the age, timing, examination findings and investigations in the vignette fit Status epilepticus better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian seizure emergency guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian seizure emergency guidance