Mehl. alcohol withdrawal + conduct and oppositional defiant disorder 03-13 (1) Flashcards
Alcoholic hallucinosis. onset?
Presents 12-48 hours after the last drink.
Alcoholic hallucinosis. what hallucinations?
Patient can have hallucinations, usually tactile (i.e., bugs crawling on skin) or visual (bugs crawling up wall).
Alcoholic hallucinosis. Tx? 1+1
Treat with benzo + thiamine.
Delirium tremens. onset?
Presents 2-4 days following last drink.
Delirium tremens. CP?
Patient will have tremulousness, tachycardia, diaphoresis, and restlessness.
Seizures can also sometimes occur.
Delirium tremens.
USMLE-favorite vignette is 40s male who gets tremulousness and tachycardia while in hospital 2ish days after surgery. Answer is just benzo.
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Delirium tremens.
Can also show up on NBME as a guy who goes from drinking 12 beers a day to suddenly only 2 beers a day.
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Delirium tremens. Tx 1+1?
benzo + thiamine.
Oppositional defiant. definition?
Argumentative and defiant behavior, often leading to problems at school with teachers and/or problems with grades.
Argumentative and defiant behavior, often leading to problems at school with teachers and/or problems with grades. Dx?
Oppositional defiant.
Oppositional defiant.
The vignette can sound like normal teenage behavior, but the emphasis will be that there is impediment to social and/or scholastic progression.
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Oppositional defiant. whats about law breaking?
Another key point is that there is no law-breaking.
If the vignette mentions anything about crimes, then the USMLE wants conduct disorder instead.
Conduct disorder. definition?
> 6-month pattern of law-breaking starting age 17 or younger
> 6-month pattern of law-breaking starting age 17 or younger. Dx?
Conduct disorder.
Conduct disorder.
Vignette might give a teenager who engages in criminal behavior, such as killing an animal, destroying property, or engaging in theft
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Conduct disorder.
USMLE won’t necessarily present to you a pattern of ongoing behavior, but rather just a snapshot of a child + ask for the diagnosis – i.e., 14-year-old killed an animal.
what’s the most likely diagnosis. answer = conduct disorder (because what he did is a crime); oppositional defiant disorder is wrong answer.
In short: In conduct disorder, the kid breaks the law. In oppositional defiant, the kid doesn’t break the law.
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