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Febrile seizure — MCCQE Part 1 MCQ

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EasySeizuresFebrile seizureMCCQE Part 1

20-month-old toddler presents with a 2-minute generalized seizure with fever. He recovers fully and examination suggests viral URI. Which of the following is the most appropriate next step?

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Correct answer: E — Reassure, treat the source of fever as appropriate and avoid routine anticonvulsants/neuroimaging

Reassure, treat the source of fever as appropriate and avoid routine anticonvulsants/neuroimaging is best because simple febrile seizure is brief, generalized and followed by full recovery. Provide only reassurance without clear follow-up or safety-netting is suboptimal because children can deteriorate quickly and follow-up must be explicit; Use adult dosing or adult pathways without paediatric adjustment is suboptimal because children require age- and weight-appropriate care; Delay assessment until the next routine visit is suboptimal because developmental, infectious and neonatal red flags require timely assessment; Give antibiotics, steroids or investigations routinely despite no indication is suboptimal because over-treatment can cause harm when supportive or targeted care is indicated. The task is to identify complex features or CNS infection.

Reference: Canadian Paediatric Society febrile seizure guidance