A 32-year-old man is being evaluated in the surgical department altered mental status. He was admitted to the hospital 3 days ago after a motor vehicle collision. He has no history of serious illness. He has experimented with intravenous illicit drugs. He drinks 3 beers and 2 glasses of whiskey daily during the week and more on the weekends with his college fraternity. On physical examination, the patient is diaphoretic, tremulous, and disoriented. There are mild hand tremors but no other neurologic abnormalities. Increased activity of which of the following central nervous system receptors is the most likely cause of this patient's condition?

Question

A 32-year-old man is being evaluated in the surgical department altered mental status. He was admitted to the hospital 3 days ago after a motor vehicle collision. He has no history of serious illness. He has experimented with intravenous illicit drugs. He drinks 3 beers and 2 glasses of whiskey daily during the week and more on the weekends with his college fraternity.  On physical examination, the patient is diaphoretic, tremulous, and disoriented.  There are mild hand tremors but no other neurologic abnormalities.  Increased activity of which of the following central nervous system receptors is the most likely cause of this patient's condition?

Quizplus · Accepted Answer

Eductional Objective: Chronic alcohol use downregulates inhibitory GABA receptors and upregulates excitatory NMDA glutamate receptors.  Therefore, sudden cessation of alcohol leads to decreased GABA activity and increased glutamate activity, resulting in CNS overexcitation (eg, agitation, disorientation, tremulousness, autonomic hyperactivity).

A 32-Year-Old Man Is Being Evaluated in the Surgical Department