Inability to fully reproduce in memory the events that occur during alcohol intoxication

# 2

*! The big drug addiction consists, except

(consists of syndromes: altered reactivity, mental dependence, physical dependence)

# 3

*! A patient, 55 years old, a handyman. Delivered to the department of addiction therapy by the ambulance team. From the medical history of the disease it is known that has been abusing alcohol since 30 years. In the last 6 years, drinking bouts lasting from 3 to 10 days, daily tolerance increased to 1.0 liters of vodka. Intoxication is interrupted for external reasons. It cannot go out of binge on its own, in private it receives detoxification therapy. For several months he was in a religious rehabilitation program for admission. After returning home, he began to accuse his wife of having contacted the guys from the rehabilitation center, that she was cheating on him with them, that they wanted to take his apartment and house. In a mental status, he is cautious, secretive, at first he is reluctant to reveal his feelings at the conversation, “You will consider me crazy, I won’t tell you my problems,” later I began to talk very actively about the behavior of my wife and children from the rehabilitation center. He explains his hospitalization with the fact that "the wife wants to make him crazy, so that he does not interfere with her." Notes that he was always jealous. There is no criticism of his condition. What condition is MOST likely in this patient?

Stage II alcoholism

Alcoholic psychosis (alcoholic paranoid - delirium of jealousy)

#4

*! Patient K., 46 years old. From the anamnesis of life and disease it is known that from childhood I grew up quiet and calm in nature. After the 8th grade, he entered the construction college, where he began to drink 200-250 ml of wine after receiving a scholarship under the influence of a fellow student. Sometimes after this, vomiting was noted. Despite the fact that he did not like the state of intoxication, he could not refuse to drink, because he was afraid of condemnation from peers. After graduating from college he was drafted into the army, where he drank whenever possible. After demobilization, he worked at a construction site and drank 200-300 ml of vodka or 400-500 ml of wine up to 3-4 times a month. Vomiting after drinking ceased to occur.
At the age of 25, he married and after that for several months refrained from drinking. Then he began to drink again as before. Sometimes the next day I could not remember certain moments of the previous evening. He tried to refrain from drinking, made promises to his wife, but after drinking one glass, he could not stop then. Subsequently, he began to drink more, 500-600 ml each. vodka or up to 1 liter of wine. In a state of alcoholic intoxication, he became rude, irritable, and conflicting, as a result of which relations in the family and at work deteriorated. After family conflicts, there were attempts to refrain from drinking, which lasted only 1-1.5 months. At such moments, he felt "as if not at ease." Towards evening he “walked about” and for a long time could not fall asleep and woke up early. For medical help at the insistence of his wife. What is the most likely diagnosis for this patient?

Signs of stage I (initial) alcoholism:

Loss of a protective gag reflex

Build-up tolerance

Partial loss of quantitative control

Palimpsests

Changes in the form of intoxication

Signs of moral decline

#5

*! Patient M., 58 years old. Delivered to the drug treatment department by the ambulance team. In the emergency room he sits alert, looks around with fear, tells the doctor the emergency room, the doctor is watching the mice running under your feet. From the anamnesis it is known that he has been abusing alcohol for the past 20 years, a psychophysical dependence on alcohol has been formed, the daily tolerance has decreased to 400.0 ml. hard liquor. According to the accompanying relatives, the last binge lasted 10 days, 2 days ago there was the last alcohol consumption, after which the patient had a sleep disturbance, became anxious, said that he hears voices from the street, sees various non-existent objects, was annoyed when relatives said that there was nothing no. In the afternoon, the condition improves slightly. In this connection he was taken to the hospital. What is the most likely diagnosis for this patient?

Stage III alcoholism

Delirium or hallucinoid?

# 6

*! Patient M., 49 years old. Delivered to the drug treatment department by the ambulance team. In the emergency room, she actively complains of severe headaches, pain in the heart, anxiety, fear, difficulty breathing, chills. From the anamnesis it is known that abuse alcohol in the last 15 years. Drunkenness is characteristic from 2 to 10 days, daily tolerance is high up to 0.7 liters of vodka. Abuses mainly with “friends”. Somatically HELL 135/110 mm Hg, heart rate 110 beats. in minutes The face is hyperemic. The skin is hyperemic, moist. During a neurological examination, a small dysarthria, staggering in the Romberg position, and a finger-nasal test are performed with a miss. In mental status, in consciousness. Contact is available, actively complains about his somatic state, grabs his heart. The mood background is unstable, with dysphoric inclusions. What is the most likely syndromic diagnosis for this patient?

Stage II alcoholism?

# 7

*! A teenager M., 15 years old, came to the emergency room of the CPP accompanied by his parents. According to the parents, in the last 2 months their son has seen sharp changes in behavior and mood, from agitation with euphoria to adynamia with a depressed mood, sometimes with irritability. Parents also report that 3 months ago they moved from another city and their son had a new company of friends. Parents also note that, against the background of an overly elevated mood, the son has increased pulsation in the neck, and the pupil dilates to most of the iris. When examined in mental status, the patient is sluggish, inhibited, answers the questions reluctantly, monosyllabic. What preliminary diagnosis is MOST likely in this patient?

?

#8

*! Patient K., 35 years old, upon examination complains of fear, a sensation of impending death, intermittent sleep with terrible dreams. Chills, tremors, sweating, and salivation occur. According to the patient, it is known that he systematically takes cocaine during the year. This condition developed 2 days after the forced cancellation.
Based on complaints, you can think about the presence of a syndromic diagnosis:

Cocaine Abstinence

#9

*! In the emergency room of a psychiatric hospital at 2 hours 30min. In the morning, patient B. was delivered for 30 years. According to reports from his wife, he has been abusing alcohol for the past 3 years. He fell ill acutely, three hours ago, after he found the patient sitting in the kitchen and drinking from the neck of a bottle. An ambulance was called due to improper behavior, did not sleep, was excited, "started talking", crawled on the floor.
In the emergency room, she is disoriented, experiencing visual, frightening hallucinations, sketchy delusional ideas of persecution, fear, and anxiety. It is in a state of psychomotor agitation. Complains of nausea, abdominal pain, fibrillar twitching of the eyelids, facial muscles, miosis, hyperhidrosis, hypersalivation. Hell - 130/90. Temperature - 37.2 C.
Assess the psychopathological state: