Status epilepticus, acute stroke management, and elevated intracranial pressure management scenarios tested on USMLE Step 2 CK.
35 cards · mixed cards · AI-written, checked twice. Edit anything.
- Status epilepticus is defined as ____ or more of continuous seizure activity.
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5 minutes- What is the definition of status epilepticus based on recurrent seizures?
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Two or more seizures occurring without full recovery of consciousness between them- What class of medication is first-line treatment for status epilepticus?
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Benzodiazepines- What is the preferred first-line benzodiazepine and route when IV access is available for status epilepticus?
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IV lorazepam- What is the preferred first-line benzodiazepine and route when IV access is not available for status epilepticus?
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Intramuscular midazolam- Name second-line agents used if status epilepticus persists after benzodiazepines.
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Fosphenytoin, levetiracetam, or valproate- Why is fosphenytoin often preferred over phenytoin for acute loading?
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It causes fewer infusion-site reactions and can be infused faster or given intramuscularly- What cardiac precaution is needed when giving IV phenytoin or fosphenytoin?
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Continuous cardiac monitoring, since infusion can cause arrhythmia and hypotension- After roughly how long does status epilepticus refractory to first- and second-line agents become 'refractory status epilepticus'?
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About 60 minutes- What is the treatment approach for refractory status epilepticus that fails second-line agents?
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Intubation with continuous IV anesthetic infusion (e.g., propofol or midazolam) and continuous EEG monitoring- Before giving antiepileptic drugs to an actively seizing patient, what bedside test should be checked immediately?
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Fingerstick glucose- If a patient remains unresponsive after visible seizure activity has stopped, what should be done?
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Start continuous EEG monitoring to rule out nonconvulsive status epilepticus- What is the maximum time window from symptom onset for giving IV alteplase in acute ischemic stroke?
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4.5 hours- What imaging study must be obtained before giving thrombolytics for a suspected acute stroke?
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Noncontrast head CT, to exclude hemorrhage- What is an absolute contraindication to IV tPA related to bleeding?
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Active internal bleeding
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