A 30-year-old woman is brought to the emergency department with acute confusion, visual hallucinations, sweating, and tremors. She has a history of alcohol dependence and recently stopped drinking 3 days ago. What is the best treatment? A) Diazepam B) Haloperidol C) Fluoxetine D) Olanzapine E) Acamprosate Correct Answer: A) Diazepam Explanation: This patient has alcohol withdrawal with delirium tremens (DTs), which can be life-threatening. Benzodiazepines (e.g., diazepam, lorazepam) are the treatment of choice to prevent seizures and control agitation. B) Haloperidol → Incorrect. Antipsychotics are not first-line and can worsen seizures. C) Fluoxetine → Incorrect. SSRIs do not treat alcohol withdrawal. D) Olanzapine → Incorrect. Antipsychotics are not first-line for DTs. E) Acamprosate → Incorrect. Acamprosate is used for long-term relapse prevention, not acute withdrawal. Key Tips for PLAB 1: ✅ Alcohol withdrawal → First-line is benzodiazepines (diazepam, chlordiazepoxide). ✅ Delirium tremens → Treat with IV benzodiazepines and supportive care. ✅ Thiamine (vitamin B1) should be given to prevent Wernicke’s encephalopathy.
