USMLE PRACTICE QUESTION OF THE WEEK

Question for January 16, 2026

A 32-year-old pregnant woman at 36 weeks of gestation presents with a generalized tonic-clonic seizure. She had severe headaches and visual changes earlier in the day. BP is 176/108 mmHg. Urinalysis shows 3+ protein. On arrival, she is postictal but arousable.

Which of the following is the most appropriate immediate management?

A. IV hydralazine

B. IV labetalol

C. IV magnesium sulfate

D. Induction of labor

E. Oral nifedipine

Get Detailed Explanation

Correct Answer:

C. IV magnesium sulfate

Correct Answer Explanation:

This patient has eclampsia (seizures in preeclampsia). The immediate step is seizure prophylaxis with IV magnesium sulfate. After stabilization, antihypertensives (e.g., hydralazine, labetalol) and expedited delivery are indicated. Immediate induction before magnesium would risk recurrent seizures. Oral nifedipine is inappropriate for acute control.

Further Insight:

Preeclampsia: new-onset hypertension + proteinuria/end-organ damage >20 weeks.
Eclampsia requires magnesium sulfate for maternal stabilization before delivery.