skip to main content

Alcohol withdrawal seizure — USMLE Step 3 MCQ

Instant feedback + full explanation. One question, done properly.

ModerateEmergency MedicineAlcohol withdrawal seizureUSMLE Step 3

A 30-year-old man is brought to the emergency department after a generalized tonic-clonic seizure. He stopped drinking alcohol 24 hours ago after consuming a pint of vodka daily for years. Temperature is 37.2°C, pulse is 118/min, blood pressure is 156/94 mm Hg, and he is tremulous and diaphoretic. Glucose is 92 mg/dL and sodium is 137 mEq/L. Which of the following is the most appropriate next step in management?

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

Reveal the answer and explanation

Correct answer: B — Chlordiazepoxide and thiamine

Alcohol withdrawal seizures are treated with benzodiazepines; thiamine should be given to prevent Wernicke encephalopathy. Phenytoin does not treat the underlying withdrawal physiology.

Reference: ASAM Alcohol Withdrawal Management Guideline