Phys Vivas · pharmacological
Opioid Benzodiazepine AND Alcohol Withdrawal — Viva Defence
DCE viva defence for Opioid Benzodiazepine AND Alcohol Withdrawal.
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Target exams
Opioid Benzodiazepine AND Alcohol Withdrawal Viva
Long Case Viva Defence
Opening statement
"This patient presents with a problem best framed as Opioid Benzodiazepine AND Alcohol Withdrawal. My priorities are to identify red flags, confirm the mechanism with purposeful investigations, start a sequenced management plan, and integrate multimorbidity and follow-up." [1] [2]
Examiner questions
Q1: "What makes this urgent?" [1]
"I look for threats to airway, perfusion, neurology, metabolism, infection or bleeding, and I escalate those before elective work-up." [1] [2]
Q2: "What is your first investigation package?" [2]
"I order tests that change management now, not a scattergun panel." [1] [2]
Q3: "Walk me through treatment." [1]
"Stabilise, treat the mechanism, prevent complications, and plan monitoring." [1] [2] [3]
Q4: "What is the classic trap?" [2]
"Treating a label without confirming the discriminating mechanism, or delaying escalation." [1] [2]
Short case
Counsel the patient on the plan, risks and warning symptoms in plain language. [1] [2]
References
- [1]Sinclair JMA, Kalk NJ, Kaar SJ, Agabio R, et al. Evidence-based consensus guidelines for the pharmacological management of substance dependence: Recommendations from the British Association for Psychopharmacology J Psychopharmacol, 2026.PMID 41731947
- [2]Figg JW, Love CA, Sorathia V, Engelbart M, et al. Benzodiazepines at the crossroads: navigating therapeutic promise and perils of misuse Ann Gen Psychiatry, 2026.PMID 41622184
- [3]Parnia S, Jain L, Ali M, Sarfraz Z, et al. Gas station heroin- tianeptine and its impact: a systematic review and exploratory analysis BMC Public Health, 2025.PMID 41136982
- [4]Szily E [The pharmacological treatment of substance use disorders] Psychiatr Hung, 2025.PMID 42412646
- [5]Haber PS, Riordan BC, Winter DT, Barrett L, et al. New Australian guidelines for the treatment of alcohol problems: an overview of recommendations Med J Aust, 2021.PMID 34601742
- [6]Doan HN, Chang MC Comparative Effectiveness of Unstable Versus Stable Resistance Training on Lower Limb Strength, Mobility, and Fear of Falling in Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials Am J Phys Med Rehabil, 2026.PMID 42468010
- [7]Liu HW, Tsai TL Virtual Reality-assisted Physiotherapeutic Training for Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis Am J Phys Med Rehabil, 2026.PMID 42468005
- [8]Osborne AK, Brown RD, Sillence E Effects of Social Media Narratives on Affective and Behavioral Responses to Menopause Content: Randomized Online Experimental Study JMIR Form Res, 2026.PMID 42467962