A 22-year-old man is undergoing an uncomplicated laparoscopic appendectomy. Intraoperatively, there was approximately 100 mL of blood loss, his urine output was 100 mL, and 1 L of lactated Ringer solution was administered. His pain has been controlled with intravenous morphine. He was admitted to the hospital 3 days ago and has not eaten in 18 hours. 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. He appears anxious. Which of the following symptoms or signs is most likely to appear earliest during this patient's hospitalization?

Question

A 22-year-old man is undergoing an uncomplicated laparoscopic appendectomy. Intraoperatively, there was approximately 100 mL of blood loss, his urine output was 100 mL, and 1 L of lactated Ringer solution was administered. His pain has been controlled with intravenous morphine. He was admitted to the hospital 3 days ago and has not eaten in 18 hours. 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. He appears anxious.   Which of the following symptoms or signs is most likely to appear earliest during this patient's hospitalization?

Quizplus · Accepted Answer

Eductional Objective: Tremulousness is typically one of the earliest symptoms of alcohol withdrawal.  Other common symptoms include gastrointestinal distress, agitation, anxiety, and autonomic disturbance.  Delirium tremens is the most severe manifestation of alcohol withdrawal and typically begins 48-96 hours after the last drink.

A 22-Year-Old Man Is Undergoing an Uncomplicated Laparoscopic Appendectomy