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Status epilepticus — USMLE Step 2 CK MCQ

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EasyEmergency MedicineStatus epilepticusUSMLE Step 2 CK

A 47-year-old African American woman comes to the hospital because of neurologic symptoms. History and focused examination are notable for generalized tonic-clonic seizure lasting more than five minutes. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and initial testing support the clinical pattern described in the stem. Which of the following is the most appropriate next step in management?

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Correct answer: D — Intravenous lorazepam

The vignette describes Status epilepticus, supported by generalized tonic-clonic seizure lasting more than five minutes. Intravenous lorazepam is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: American Epilepsy Society Status Epilepticus Guideline