Tuesday, May 21, 2019

Repeated USMLE Questions Step 2 CK- 269

A 26-year-old man is brought to the ER by a policeman because he was drunk while driving. He was arrested twice last year for the same reason. He also missed work for a few times because he was drunk. His girlfriend broke up with him 3 months ago because he promised her several times to stop drinking but he couldn’t. He mentioned that he couldn’t stop drinking because every time he quit, he feels horrible symptoms and he has to go back to drink more than before. His family and friends are not happy with him because of his drinking problems.

Which one of these factors suggests patient’s alcohol dependence rather than abuse?

A - The patient was arrested 3 times for drinking under the influence (DUI)

B - The patient missed work for a few times

C - The patient broke up with his girlfriend due to his drinking problems

D - The patient experienced withdrawal symptoms

E - His family and friends are not happy with him because of drinking


The two main features of drug dependence are tolerance and/or withdrawal symptoms. In this patient, the withdrawal symptoms that he experienced every time he quit are the clues for alcohol dependency. Other choices are considered substance abuse rather than dependence.

The correct answer is D

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