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Hypoglycaemic seizure — SCE Acute Medicine MCQ

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EasyAcute Neurological PresentationsHypoglycaemic seizureSCE Acute Medicine

A 58-year-old man is assessed on the acute medical unit. He has type 1 diabetes and is found fitting in the waiting area. Capillary glucose is 1.8 mmol/L. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most important immediate action?

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Correct answer: B — Give intravenous glucose after checking capillary glucose

Give intravenous glucose after checking capillary glucose is the best answer because severe hypoglycaemia causing seizure needs immediate glucose replacement. Stop the suspected causative drug and resuscitate is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Glucagon is useful if intravenous access is not available, but IV glucose is rapid in hospital.

Reference: JBDS hypoglycaemia guideline; BNF