USMLE · Question #597
A 45-year-old male is brought to the emergency department by the police who found him wandering around a park at midnight. Physical examination reveals bilateral hand tremors. Laboratory tests…
The correct answer is B. lorazepam. The patient is most likely experiencing alcohol withdrawal. Signs of alcohol intoxication include ataxia, slurred speech and emotional lability. Laboratory findings sensitive for alcohol use include serum gamma-glutamyl transferase (GGT) and an AST to ALT ratio greater than 2:1…
Question
A 45-year-old male is brought to the emergency department by the police who found him wandering around a park at midnight. Physical examination reveals bilateral hand tremors. Laboratory tests reveal elevated serum gamma-glutamyl transferase. Thirty hours after he is admitted to the hospital he develops generalized seizures. The most appropriate treatment for this patient's seizures is
Options
- Acarbamazepine
- Blorazepam
- Cphenytoin
- Dthiopental
- Ezolpidem
How the community answered
(40 responses)- A3% (1)
- B78% (31)
- C3% (1)
- D10% (4)
- E8% (3)
Explanation
The patient is most likely experiencing alcohol withdrawal. Signs of alcohol intoxication include ataxia, slurred speech and emotional lability. Laboratory findings sensitive for alcohol use include serum gamma-glutamyl transferase (GGT) and an AST to ALT ratio greater than 2:1 in chronic alcoholics. Alcohol withdrawal may present with tremors, insomnia, diaphoresis, agitation, delirium tremens 48-96 hours after the last drink, alcoholic hallucinosis 12-48 hours after the last drink and withdrawal seizures 6-48 hours after the last drink. The treatment of these seizures is with a benzodiazepam such as lorazepam.
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