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OVERVIEW
This page is dedicated to organizing various examples of standardized exam questions whose answer is alcohol withdrawal. While this may seem a odd practice, it is useful to see multiple examples of how alcohol withdrawal will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
KEY CHARACTERISTICS OF THIS CONDITION (ON EXAMS)
When it comes to standardized exams, each topic has its own “code” marked by key buzzwords, lab findings, clues, etc. If you are well versed in this code you will be able to more quickly identify the condition that is being discussed, and get the right answer on the exam you are taking. Below is the “code” for alcohol withdrawal.
- Tachycardia
- Restlessness
- Diaphoresis
- Anxiety
QUESTION EXAMPLES
Question # 1
The on call surgical intern is paged to see a 32 year old man who is having a seizure. The patient recently underwent an emergent appendectomy one day ago. The surgery was uneventful, however he has gradually become more restless and tremulous overnight. The patient has no prior health records at the hospital. he reported a medical history that was only remarkable for gastritis. Omeprazole is one of his home medications. The patient’s temperature is 100.4°C, his blood pressure is 146/95, his pulse is 117, and his respirations are 19/min. Examination is remarkable for diaphoresis and tremors. His wound incision shows no evidence of any inflammation. His laboratory results are only notable for elevated AST/ALT (216 U/L and 225 U/L respectively). What is the most likely diagnosis for this patient?
Explanation # 1
Question # 2
A 42 year old man is hospitalized for acute cholecystitis and is being evaluated for agitation and anxiety. He underwent a laparoscopic cholecystectomy without any surgical complications. Tow days after admission, the patient begins to experience anxiety, severe agitation, tremulousness, and also acts verbally abusive to the to the nursing staff. He has no past history of medical issues. The patient denies any tobacco usage, but does admit to drinking 6-8 beers daily for the last several years. He has no known drug allergies and his family history is unremarkable. His blood pressure is 165/90 mm Hg and pulse is 110/min. Physical exam shows hand tremors bilaterally. What is the most likely diagnosis for this patient?
Explanation # 2
Question # 3
A 67-year-old man is admitted to the emergency room after he was found having a seizure on the side of the road. After the seizure passed, the patient was found to be agitated and disoriented. Vital signs upon arrival are as follows: blood pressure 170/100 mm Hg, pulse 115 beat/min. What substance related condition could explain this patient’s presentation?
Explanation # 3
Question # 4
Explanation # 4
TESTABLE FACTS ABOUT THIS TOPIC (BEYOND ITS IDENTIFICATION)
Many questions on standardized exams go beyond simply recognizing the underlying topic. Often there are specific testable facts regarding some aspect of the topic’s pathophysiology/management/clinical implications that are commonly asked. Some of these are listed below:
- Treatment: typically treated with benzodiazepine medications (like diazepam)
Page Updated: 09.20.2016