Toxicology: alcohol withdrawal delirium: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Toxicology: alcohol withdrawal delirium

Sample item

A chronic drinker admitted with a fracture develops tremor, vivid visual hallucinations, fever, tachycardia and disorientation on the third day. What is the drug of choice?

APhenytoinBPropranololCBenzodiazepines such as lorazepam or diazepamDHaloperidol alone

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Benzodiazepines such as lorazepam or diazepam

This is delirium tremens, due to withdrawal-related loss of GABA inhibition. Benzodiazepines are the drug of choice and prevent seizures, and thiamine is given alongside. Antipsychotics alone lower the seizure threshold, phenytoin is ineffective for withdrawal seizures, and beta-blockers mask signs without treating the cause.

Option by option

A. Phenytoin
Phenytoin does not prevent or treat alcohol withdrawal seizures.
B. Propranolol
Propranolol may mask the tachycardia and tremor but does not prevent delirium or seizures.
C. Benzodiazepines such as lorazepam or diazepam (correct)
Correct. Benzodiazepines replace the lost GABA-mediated inhibition and reduce complications.
D. Haloperidol alone
Haloperidol alone may worsen seizures and does not treat the withdrawal state.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is C, Benzodiazepines such as lorazepam or diazepam. This is delirium tremens, due to withdrawal-related loss of GABA inhibition.

Why is "Phenytoin" not the answer?

Phenytoin does not prevent or treat alcohol withdrawal seizures.

Why is "Propranolol" not the answer?

Propranolol may mask the tachycardia and tremor but does not prevent delirium or seizures.

Why is "Haloperidol alone" not the answer?

Haloperidol alone may worsen seizures and does not treat the withdrawal state.

What concept does this question test?

It tests Toxicology: alcohol withdrawal delirium in Forensic Medicine. Benzodiazepines are the drug of choice and prevent seizures, and thiamine is given alongside. Antipsychotics alone lower the seizure threshold, phenytoin is ineffective for withdrawal seizures, and beta-blockers mask signs without treating the cause.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Toxicology: alcohol withdrawal delirium?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.