Think Like A Psychiatrist - Alcohol Abuse and Altered Mental Status

Put your knowledge and skills to the test with a case of a 26 year old man who presents to the ED with intermittent confusion, weakness, lethargy, abdominal pain and jaundice.  With regards to his past medical and psychiatric history, the patient has an alcohol use disorder, and drinks up to 1L of vodka a day.  He was recently hospitalized 6 months ago for alcoholic hepatitis and severe hyponatremia.  Blood alcohol and urine drug screens are negative, and a head CT is done to rule out an acute intracranial pathology.

What is causing this patient's symptoms? How would you manage this patient?

"Sober Today, But Lethargic and Confused" by Kathryn Faloba, Viwek S. Bisen, Anthony M. Tobia, Adam J. Trenton, and Aphrodite M. Zimmerman (Current Psychiatry)

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