Toxicology: alcohol withdrawal delirium: practice question

A General Medicine 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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General Medicine · Toxicology: alcohol withdrawal delirium

Sample item

A 45-year-old heavy drinker admitted with a fractured femur develops tremor, tachycardia, fever, disorientation and visual hallucinations of small animals on day 3. What is the drug of choice?

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

The answer and the reasoning

C. A benzodiazepine such as diazepam or lorazepam

Delirium tremens occurs 48 to 96 hours after the last drink and carries significant mortality. Benzodiazepines are the first-line treatment as they reduce seizures and delirium, along with thiamine and fluids. Antipsychotics lower the seizure threshold and are only adjuncts.

Option by option

  • A. Haloperidol alone

    Haloperidol alone does not prevent seizures and may worsen them.

  • B. Propranolol alone

    Propranolol masks autonomic signs without treating the withdrawal.

  • C. A benzodiazepine such as diazepam or lorazepam (correct)

    Correct. Benzodiazepines treat withdrawal and prevent seizures.

  • D. Phenytoin

    Phenytoin is ineffective for alcohol withdrawal seizures.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is C, A benzodiazepine such as diazepam or lorazepam. Delirium tremens occurs 48 to 96 hours after the last drink and carries significant mortality.

Why is "Haloperidol alone" not the answer?

Haloperidol alone does not prevent seizures and may worsen them.

Why is "Propranolol alone" not the answer?

Propranolol masks autonomic signs without treating the withdrawal.

Why is "Phenytoin" not the answer?

Phenytoin is ineffective for alcohol withdrawal seizures.

What concept does this question test?

It tests Toxicology: alcohol withdrawal delirium in General Medicine. Benzodiazepines are the first-line treatment as they reduce seizures and delirium, along with thiamine and fluids. Antipsychotics lower the seizure threshold and are only adjuncts.

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 Toxicology: alcohol withdrawal delirium?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.