Substance use: kindling in alcohol withdrawal: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Substance use: kindling in alcohol withdrawal

Sample item

A 48-year-old man has completed several alcohol detoxifications over the years. His latest withdrawal is complicated by seizures, although he was drinking less than before. Which concept best explains the progressively worse withdrawals?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Kindling

Kindling is the progressive sensitisation of neural circuits to repeated withdrawal episodes, so that each later withdrawal is more severe, with more seizures and delirium. It is the reason for aiming to avoid repeated unsupervised withdrawals.

Option by option

  • A. Craving

    Craving is the urge to use a substance and does not alter withdrawal severity.

  • B. Protracted abstinence syndrome

    Protracted abstinence refers to long-lasting mood and sleep disturbance after acute withdrawal.

  • C. Cross-tolerance

    Cross-tolerance is tolerance to a related drug, such as benzodiazepines in an alcoholic.

  • D. Kindling (correct)

    Correct. Repeated withdrawals sensitise the brain, so later episodes become worse.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is D, Kindling. Kindling is the progressive sensitisation of neural circuits to repeated withdrawal episodes, so that each later withdrawal is more severe, with more seizures and delirium.

Why is "Craving" not the answer?

Craving is the urge to use a substance and does not alter withdrawal severity.

Why is "Protracted abstinence syndrome" not the answer?

Protracted abstinence refers to long-lasting mood and sleep disturbance after acute withdrawal.

Why is "Cross-tolerance" not the answer?

Cross-tolerance is tolerance to a related drug, such as benzodiazepines in an alcoholic.

What concept does this question test?

It tests Substance use: kindling in alcohol withdrawal in Psychiatry. It is the reason for aiming to avoid repeated unsupervised withdrawals.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Substance use: kindling in alcohol withdrawal?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.