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Alcohol withdrawal — MCCQE Part 1 MCQ

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EasySubstance UseAlcohol withdrawalMCCQE Part 1

A 53-year-old man trembles, sweats and sees insects on the wall 18 hours after stopping heavy daily alcohol use. Blood pressure is 168/96 mmHg and heart rate is 118/min. Which of the following is the most appropriate treatment?

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Correct answer: B — Benzodiazepine-based withdrawal management plus thiamine before glucose when possible

Autonomic hyperactivity and hallucinations after cessation of heavy alcohol use suggest significant withdrawal, treated with benzodiazepines and thiamine to reduce Wernicke risk. Antipsychotics may be adjunctive but do not prevent withdrawal seizures. Relapse-prevention medications are considered after acute stabilization.

Reference: Canadian substance use guidance; CAMH alcohol use disorder resources