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Alcohol withdrawal delirium — ABEM Board MCQ

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ModeratePsychiatric emergenciesAlcohol withdrawal deliriumABEM Board

A 51-year-old man with alcohol use disorder arrives with tremor and confusion 3 days after his last drink. Triage acuity is ESI 2; T 100.9 F, BP 178/102 mm Hg, HR 138/min. He is diaphoretic, hallucinating, and severely agitated. Glucose is normal. Which of the following is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Give benzodiazepines and supportive care with thiamine

Delirium tremens is treated with benzodiazepines, supportive care, and thiamine; antipsychotics may be adjunctive but not sole treatment.

Reference: ASAM alcohol withdrawal guideline