Seizure Disorders USMLE Step 1 Practice Question
A 24-year-old woman with no prior seizure history presents after a single generalized tonic-clonic seizure following 3 days of poor sleep, intense stress from medical school exams, and binge drinking the night before. Vital signs: BP 118/76, HR 92, RR 16, Temp 37.2°C, SpO2 98%. Serum glucose 94 mg/dL and electrolytes are normal. Head CT shows no acute abnormalities. She denies tongue biting or incontinence. Which of the following is the most appropriate management?
Answer choices
- AAdmit for continuous EEG monitoring for 48 hours
- BStart two antiepileptic drugs to prevent recurrence
- CPerform lumbar puncture to rule out infection
- DObserve without antiepileptic drugs and address provoked seizure triggersCorrect answer
- EStart antiepileptic drug monotherapy immediately
- FPrescribe short-term lorazepam rescue therapy for home seizure recurrence prevention
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