Status Epilepticus and Antiseizure Medication — Board-Style Questions

What this deck covers

Status Epilepticus and Antiseizure Medication in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Whether to wait a little longer
2. A cannula in on the first attempt
3. Still going after the first dose
4. After two doses have failed
5. Precautions while it runs
6. When the algorithm runs out
7. Convulsing after a day of vomiting
8. Two days old and jerking
9. Nothing has worked, and nothing found
10. Forty minutes later, still out
11. Limp after the second dose
12. A rash two weeks into the new drug
13. She would prefer the pill
14. Worse before meals
15. A blood level at every visit
16. Three fits after two quiet years
17. Seizure-free, and suddenly furious
18. Two drugs, one year, a spot on the scan

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Wait until thirty minutes have passed, Intravenous lorazepam, Oral levetiracetam through a nasogastric tube, Give it, A trial of the ketogenic diet by nasogastric tube, Intramuscular glucagon, Intravenous lorazepam, as in older children, Therapeutic hypothermia, Stop the valproate, She should switch from carbamazepine to lamotrigine, The ketogenic diet, Missed doses, Non-convulsive seizures, A vagus nerve stimulator.

Clinical pearls from this deck

• Five minutes is not a guideline number. It is the moment the brain stopped being able to stop.
• The first drug is always a benzodiazepine. With a line in, that means lorazepam.
• Two benzodiazepines. Count the one the ambulance gave.
• While the second benzodiazepine goes in, someone should already be drawing up the levetiracetam.
• Phenytoin is the one drug in the algorithm that can stop the heart while it stops the seizure. Watch the monitor.
• When the algorithm runs out, the answer is an anaesthetist, not another ampoule.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Neurology case decks · pediatric reference values.