substance abuse...case 1 - zkadhem

[ArchivalUser]

sorry for interrupting:
But regarding best approach to alcoholic pt (Q2)

According to UW:

The approach to a patient with alcoholism is a stepwise process.

Step 1: Inquire about current and past alcohol use, and about a family history of alcohol problems.
Step 2: Obtain information regarding the type, quantity and frequency of alcohol use. This is useful to distinguish between moderate and heavy drinkers.
Step 3: Use a standard screening questionnaire such as CAGE.
Step 4: Ask more specific questions based upon steps 1 to 3 in patients with suspected alcohol problems.

Studies have shown screening questionnaires to be superior to both laboratory testing and inquiries about quantity or frequency of drinking in evaluating individuals for alcohol abuse or dependence. Appropriate

Screening questionnaires include CAGE, AUDIT, and TWEAK.

[ArchivalUser]

You are considering whether or not this patient has delirium tremens (DT). If she indeed has DT, which of the following would be true?
A) There is a 50% chance of minor withdrawal developing into major withdrawal (delirium tremens
or DT).
B) Visual hallucinations are uncommon in DT.
C) Symptoms of DT could easily be confused for dementia.
D) Her last drink would need to be about 1 week ago.
E) Autonomic instability is present in DT.

[ArchivalUser]

Ans E: Autonomic instability is present in DT
??

[ArchivalUser]

EEE

[ArchivalUser]

Discussion
The correct answer is E. Autonomic instability with elevated pulse, blood pressure, and fever are common in DT. Answer A is incorrect. Minor withdrawal symptoms are quite common, but DT develops in only 3“5% of patients undergoing alcohol withdrawal. Answer B is incorrect. Visual hallucinations are common in DT; auditory hallucinations are less likely. Answer C is incorrect. Withdrawal delirium typically presents acutely over a matter of hours or days, whereas in dementia, the cognitive decline is over a course of months to years. Additionally, autonomic instability is not a feature of early dementia. Finally, D is incorrect because the risk for DT usually peaks 72 hours after the last drink.

[ArchivalUser]

Which medication would be the best choice for delirium tremens in a patient who is vomiting
profusely and who has no IV access?
A) Diazepam (Valium).
B) Alprazolam (Xanax).
C) Chlordiazepoxide (Librium).
D) Lorazepam (Ativan).
E) Clonazepam (Klonopin)

[ArchivalUser]

DDD

[ArchivalUser]

given im

[ArchivalUser]

Discussion
The correct answer is D. Lorazepam is absorbed well intramuscularly and can be given IV as well. Thus it can be administered to a patient who is vomiting.

[ArchivalUser]

Alcohol withdrwal very nicely covered
what is ur source zkadhem