Psych: Delirium Tremens: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Delirium Tremens🎧 A high-yield breakdown of severe alcohol withdrawal – perfect for rapid revision and clinical scenarios.🧠 Key Learning Points📌 Definition• Delirium tremens (DT) is a life-threatening complication of alcohol withdrawal marked by confusion, agitation, hallucinations, and autonomic overactivity.• It typically occurs 48–96 hours after cessation or reduction of heavy alcohol use.📌 Causes & Risk Factors• Abrupt cessation of chronic alcohol intake• Previous episodes of withdrawal or DT• Older age• Liver disease• Concurrent illness or infection• Recent binge drinking🧠 Mnemonic: HALT = Heavy use, Ageing, Liver disease, Trauma/infection📌 Pathophysiology• Chronic alcohol boosts GABA (inhibitory) and suppresses glutamate (excitatory).• Withdrawal suddenly removes GABA effect → unopposed excitatory neurotransmission → CNS hyperactivity.• Result: Delirium, tremor, autonomic storm.📌 Symptoms• Delirium (confusion, disorientation)• Hallucinations (visual/auditory)• Tremors, agitation, anxiety• Autonomic instability: tachycardia, hypertension, fever, sweating• Seizures🧠 Mnemonic: SHAFTED = Sweating, Hallucinations, Agitation, Fever, Tremor, Elevated BP, Delirium📌 Differential Diagnosis• Wernicke’s encephalopathy• Schizophrenia, bipolar disorder• Encephalitis, stroke• Sepsis, metabolic derangement• Benzodiazepine withdrawal• Drug-induced psychosis📌 Diagnosis• Clinical diagnosis based on history & signs• CIWA-Ar scale for severity• Bloods: LFTs, U&Es, FBC, glucose• CT brain if neuro signs to exclude other causes🧠 Tip: CIWA score >20 = severe withdrawal, consider DT📌 Management• Supportive care: quiet environment, fluids, nutrition• Benzodiazepines: diazepam or lorazepam (fixed or symptom-triggered)• IV thiamine: to prevent/treat Wernicke’s encephalopathy• Monitor vitals, ECG, glucose• Refractory cases → ICU + phenobarbital, propofol, or dexmedetomidine• Multidisciplinary input: psychiatry, addiction, ICU if needed🧠 Mnemonic: SBM = Supportive, Benzos, Monitor📌 Complications• Seizures• Aspiration pneumonia• Cardiac arrhythmias• Death if untreated• Falls, injury during agitation📌 Prognosis• With early treatment: recovery within 5–7 days, <5% mortality• Without treatment: up to 37% mortality historically📎 More MSRA Resources for Delirium Tremens📝 Revision Notes: https://www.passthemsra.com/topic/delirium-tremens-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/delirium-tremens-flashcards/💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/delirium-tremens-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/delirium-tremens-rapid-quiz/🎓 Full Course: https://www.passthemsra.com/courses/psychiatry-for-the-msra/#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQ&ANotes #MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision #MSRARevisionWebsite #Psychiatry #DeliriumTremens