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Alcohol withdrawal delirium — ABEM Board MCQ

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ModeratePsychiatric emergenciesAlcohol withdrawal deliriumABEM Board

A 52-year-old man arrives as ESI 2 with agitation, hallucinations, tremor, and diaphoresis 24 hours after his last drink. BP 172/98, HR 132, temperature 38.0 C. He has no focal neurologic deficit and glucose is normal. Which of the following is the most likely diagnosis?

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Reveal the answer and explanation

Correct answer: BAlcohol withdrawal delirium

Autonomic hyperactivity, tremor, hallucinations, and recent cessation of heavy alcohol use support severe alcohol withdrawal.

Reference: ASAM alcohol withdrawal guideline; Tintinalli Emergency Medicine