skip to main content

Serotonin syndrome — RCPSC EM MCQ

Instant feedback + full explanation. One question, done properly.

HardPsychiatric emergenciesSerotonin syndromeRCPSC EM

A 58-year-old with CT-confirmed aneurysmal subarachnoid haemorrhage is alert with BP 210/120 mmHg and no signs of herniation. Before the aneurysm is secured, which blood-pressure approach is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Titrate IV antihypertensive therapy to keep systolic pressure below 160 mmHg

The best answer is “Titrate IV antihypertensive therapy to keep systolic pressure below 160 mmHg”. Before definitive aneurysm treatment, control severe hypertension while preserving cerebral perfusion. Canadian emergency guidance uses a systolic target below 160 mmHg, with alert patients often managed nearer 140 mmHg and transfer to neurosurgical or neurointerventional care. Extreme lowering risks cerebral ischaemia, while no treatment, oral-only therapy or diuresis do not control rebleeding risk safely.

Reference: Emergency Care BC: Subarachnoid Hemorrhage—Treatment: https://emergencycarebc.ca/clinical_resource/clinical-summary/subarachnoid-hemorrhage-treatment/