Substance use: risk of delirium tremens: 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: risk of delirium tremens

Sample item

A 50-year-old alcohol-dependent man is admitted for a hernia repair. Which feature most strongly predicts that he will develop delirium tremens?

AA previous episode of delirium tremens or withdrawal seizuresBAge under 25 yearsCA low daily intake of alcoholDA short history of drinking of under one year

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

The answer and the reasoning

A. A previous episode of delirium tremens or withdrawal seizures

Risk factors for severe withdrawal and delirium tremens include a prior history of delirium tremens or withdrawal seizures, high daily intake, long duration of dependence, older age, concurrent acute illness and electrolyte disturbance. These patients need early prophylactic benzodiazepines and thiamine.

Option by option

A. A previous episode of delirium tremens or withdrawal seizures (correct)
Correct. Previous severe withdrawal predicts recurrence, in keeping with kindling.
B. Age under 25 years
Older age rather than very young age increases the risk.
C. A low daily intake of alcohol
Higher daily intake, not low intake, raises the risk.
D. A short history of drinking of under one year
Long duration of heavy use, not a short history, raises the risk.

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.

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, A previous episode of delirium tremens or withdrawal seizures. Risk factors for severe withdrawal and delirium tremens include a prior history of delirium tremens or withdrawal seizures, high daily intake, long duration of dependence, older age, concurrent acute illness and electrolyte disturbance.

Why is "Age under 25 years" not the answer?

Older age rather than very young age increases the risk.

Why is "A low daily intake of alcohol" not the answer?

Higher daily intake, not low intake, raises the risk.

Why is "A short history of drinking of under one year" not the answer?

Long duration of heavy use, not a short history, raises the risk.

What concept does this question test?

It tests Substance use: risk of delirium tremens in Psychiatry. These patients need early prophylactic benzodiazepines and thiamine.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: risk of delirium tremens?

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.