Psychiatry

Intoxication: Restlessness, ↑ diuresis, muscle twitching. Withdrawal: Headache, difficulty concentrating, flu-like symptoms.

Intoxication: Restlessness Withdrawal: Irritability, anxiety, restlessness, difficulty concentrating.- Treatment: nicotine patch, gum, or lozenges; bupropion/varenicline.

Physiologic tolerance and dependence on alcohol with symptoms of withdrawal when intake is interrupted.  Complications: alcoholic cirrhosis, hepatitis, pancreatitis, peripheral neuropathy, testicular atrophy. Treatment: disulfiram (to condition the patient to abstain from alcohol use), acamprosate (blocks central glutamate receptors), naltrexone (blocks µ opioid receptor, reduces cravings), supportive care.- Support groups such as Alcoholics Anonymous are helpful in sustaining abstinence and supporting patient and family.

Caused by vitamin B1 deficiency.  Triad of confusion, ophthalmoplegia, ataxia (Wernicke encephalopathy).- May progress to irreversible memory loss, confabulation, personality change (Korsakoff syndrome). - Associated with periventricular hemorrhage/necrosis of mammillary bodies. - Symptoms may be precipitated by giving dextrose before administering vitamin B1 to a patient with thiamine deficiency. Treatment: IV vitamin B1.

Pervasive pattern of distrust & suspiciousness beginning in early adulthood & occuring in a variety of settings.- Believes being exploited & deceived by others- Interprets benign comments & events as threats; reacts angrily- Bears grudges- Questions loyalty of partner without justification

Involves one or more motor or verbal ticks (but not both vs Tourette syndrome) for ≥1 year.