Psychiatry High-Yield: Alcohol Use Disorder (AUD)
Alcoholism, now formally classified as Alcohol Use Disorder (AUD), is a chronic relapsing brain disease characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.
Clinical Manifestations
| Feature | Description |
|---|---|
| Tolerance | Need for markedly increased amounts to achieve intoxication or the desired effect. |
| Withdrawal | Characteristic syndrome occurring upon cessation (e.g., tremors, anxiety, delirium tremens). |
| Craving | Strong desire or urge to consume alcohol. |
Management Priorities
- Detoxification: Medically supervised withdrawal; Benzodiazepines (e.g., Diazepam, Lorazepam) are the drugs of choice.
- Pharmacotherapy: Naltrexone (reduces craving), Acamprosate (maintains abstinence), and Disulfiram (deterrent).
- Psychosocial: Motivational Interviewing (MI), Cognitive Behavioral Therapy (CBT), and support groups like Alcoholics Anonymous (AA).
High-Yield Exam Pearls:
- Delirium Tremens (DTs): A medical emergency; monitor for severe autonomic hyperactivity and hallucinations.
- Wernicke-Korsakoff Syndrome: Caused by Thiamine (Vitamin $B_1$) deficiency. Always administer Thiamine before glucose in chronic alcoholics to prevent precipitating Wernicke’s encephalopathy.
- CAGE Questionnaire: A simple, high-yield screening tool (Cut down, Annoyed, Guilty, Eye-opener).