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Welcome to today’s episode of AudioBoards — the first episode of our Intern Series, your crash course through the most common hospital conditions.

Alcohol withdrawal occurs when a chronic heavy drinker suddenly stops or significantly reduces alcohol intake, and symptoms depend on time since the last drink.

Within 6 to 36 hours, patients develop tremors, anxiety, sweating, GI upset, and tongue fasciculations.
From 12 to 48 hours, risk increases for withdrawal seizures and alcoholic hallucinosis — visual or tactile hallucinations while oriented.
From 48 to 96 hours is the most dangerous phase — Delirium Tremens — with confusion, autonomic instability, tachycardia, hypertension, hyperthermia, and up to 5% mortality.

Why does this happen? Think of the brain like a car with two pedals.
The brake is GABA — calming.
The gas is glutamate — stimulating. Alcohol acts like extra GABA, slamming the brake. With chronic drinking, the brain adapts by removing GABA receptors and increasing glutamate receptors — creating tolerance. When alcohol stops, the brake is weak and the gas pedal is floored: low GABA, high glutamate. The nervous system enters overdrive, causing tremors, anxiety, sweating, tachycardia, hypertension, hallucinations, seizures, and delirium tremens.

Severity is measured using the CIWA scale, which guides symptom-triggered treatment rather than fixed dosing.

CIWA <10: outpatient care, often gabapentin
CIWA 10–15: outpatient or ED with long-acting benzodiazepines like diazepam or chlordiazepoxide
CIWA >15–20: inpatient symptom-triggered benzodiazepines
CIWA >20: severe withdrawal requiring intensive monitoring

Benzodiazepines are preferred for self-tapering effects. In liver disease, use LOT drugs — lorazepam, oxazepam, temazepam. If inadequate, phenobarbital may be added with ICU-level monitoring.

Hospitalized patients receive thiamine, fluids, and nutrition to prevent Wernicke’s encephalopathy.

Symptom-triggered dosing is preferred, with front-loading for severe withdrawal (CIWA ≥19).

Dosing in chlordiazepoxide equivalents:

Mild: 25–50 mg PO
Moderate: 50–100 mg PO
Severe: 75–100 mg PO

Symptom-triggered: 25–100 mg PO every 4–6 hours when CIWA ≥10, with PRN doses. Fixed taper:
Day 1 q4–6h
Day 2 q6–8h
Day 3 q8–12h
Day 4 bedtime
Optional Day 5 bedtime

Front-loading: 50–100 mg PO every 1–2 hours until CIWA <10 or for three doses

Phenobarbital: 10 mg/kg IV over 30 minutes or 60–260 mg PO/IM

Thanks for listening to AudioBoards. Stay tuned for more educational content in our next episode! The views and opinions expressed on the AudioBoards Podcast do not necessarily reflect those of our employers. This podcast is for educational purposes only and should not be used to diagnose or treat any medical conditions. It is not a substitute for professional medical advice. Always consult a qualified, board-certified healthcare provider for any medical concern.

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AudioBoards is an audio-learning platform designed to help you review key topics and clinical vignettes while on the move. With the convenience of headphones, you can listen and learn as you go about your day—whether doing household chores, running errands or during your daily workout. This platform lets you make the most of small pockets of time, transforming mundane tasks into valuable learning opportunities.

Elevate your internal medicine knowledge without letting a busy schedule hold you back. Try AudioBoards today and enhance your ability to retain important information—one audio lesson at a time.

Our goal is to enhance understanding of medical principles while emphasizing that this content is for informational purposes only and not a substitute for professional clinical guidance. Tune in to expand your medical knowledge and stay informed about current trends in medicine! 

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Welcome to today’s episode of Audio Boards, today, we’re diving into the classification of personality disorders and the available treatment options. 

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AudioBoards is an audio-learning platform designed to help you review key topics and clinical vignettes while on the move. With the convenience of headphones, you can listen and learn as you go about your day—whether doing household chores, running errands or during your daily workout. This platform lets you make the most of small pockets of time, transforming mundane tasks into valuable learning opportunities.

Elevate your internal medicine knowledge without letting a busy schedule hold you back. Try AudioBoards today and enhance your ability to retain important information—one audio lesson at a time.

Our goal is to enhance understanding of medical principles while emphasizing that this content is for informational purposes only and not a substitute for professional clinical guidance. Tune in to expand your medical knowledge and stay informed about current trends in medicine! 

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Welcome back to another episode of AudioBoards. Today, we're diving into the common sleep disorders.

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AudioBoards is an audio-learning platform designed to help you review key topics and clinical vignettes while on the move. With the convenience of headphones, you can listen and learn as you go about your day—whether doing household chores, running errands or during your daily workout. This platform lets you make the most of small pockets of time, transforming mundane tasks into valuable learning opportunities.

Elevate your internal medicine knowledge without letting a busy schedule hold you back. Try AudioBoards today and enhance your ability to retain important information—one audio lesson at a time.

Our goal is to enhance understanding of medical principles while emphasizing that this content is for informational purposes only and not a substitute for professional clinical guidance. Tune in to expand your medical knowledge and stay informed about current trends in medicine! 

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Welcome back to Audioboards. Today, we’re diving into three liver conditions that are incredibly significant: Non-Alcoholic Fatty Liver Disease, Alcoholic Liver Disease, and Cirrhosis.

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AudioBoards is an audio-learning platform designed to help you review key topics and clinical vignettes while on the move. With the convenience of headphones, you can listen and learn as you go about your day—whether doing household chores, running errands or during your daily workout. This platform lets you make the most of small pockets of time, transforming mundane tasks into valuable learning opportunities.

Elevate your internal medicine knowledge without letting a busy schedule hold you back. Try AudioBoards today and enhance your ability to retain important information—one audio lesson at a time.

Our goal is to enhance understanding of medical principles while emphasizing that this content is for informational purposes only and not a substitute for professional clinical guidance. Tune in to expand your medical knowledge and stay informed about current trends in medicine! 

Send us Fan Mail

Welcome back to Audioboards. Today, we’re diving into two common conditions: Irritable Bowel Syndrome, or IBS, and Diverticular Disease, exploring their diagnostic criteria, pathophysiology, and treatment strategies.

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AudioBoards is an audio-learning platform designed to help you review key topics and clinical vignettes while on the move. With the convenience of headphones, you can listen and learn as you go about your day—whether doing household chores, running errands or during your daily workout. This platform lets you make the most of small pockets of time, transforming mundane tasks into valuable learning opportunities.

Elevate your internal medicine knowledge without letting a busy schedule hold you back. Try AudioBoards today and enhance your ability to retain important information—one audio lesson at a time.

Our goal is to enhance understanding of medical principles while emphasizing that this content is for informational purposes only and not a substitute for professional clinical guidance. Tune in to expand your medical knowledge and stay informed about current trends in medicine! 

Send us Fan Mail

Welcome to today’s episode where we’re diving into Ulcerative Colitis, exploring its symptoms, diagnosis, risk factors, and treatment options.

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AudioBoards is an audio-learning platform designed to help you review key topics and clinical vignettes while on the move. With the convenience of headphones, you can listen and learn as you go about your day—whether doing household chores, running errands or during your daily workout. This platform lets you make the most of small pockets of time, transforming mundane tasks into valuable learning opportunities.

Elevate your internal medicine knowledge without letting a busy schedule hold you back. Try AudioBoards today and enhance your ability to retain important information—one audio lesson at a time.

Our goal is to enhance understanding of medical principles while emphasizing that this content is for informational purposes only and not a substitute for professional clinical guidance. Tune in to expand your medical knowledge and stay informed about current trends in medicine! 

Send us Fan Mail

Welcome to today’s episode where we’re diving into Crohn disease, exploring its symptoms, diagnosis, risk factors, treatment options, and potential complications. 

Support the show

AudioBoards is an audio-learning platform designed to help you review key topics and clinical vignettes while on the move. With the convenience of headphones, you can listen and learn as you go about your day—whether doing household chores, running errands or during your daily workout. This platform lets you make the most of small pockets of time, transforming mundane tasks into valuable learning opportunities.

Elevate your internal medicine knowledge without letting a busy schedule hold you back. Try AudioBoards today and enhance your ability to retain important information—one audio lesson at a time.

Our goal is to enhance understanding of medical principles while emphasizing that this content is for informational purposes only and not a substitute for professional clinical guidance. Tune in to expand your medical knowledge and stay informed about current trends in medicine! 

Send us Fan Mail

Welcome to today’s episode where we’re diving into malabsorption disorders—conditions where the body has difficulty absorbing essential nutrients, leading to a wide range of symptoms and complications. We'll touch on the causes, types, and treatments.

Support the show

AudioBoards is an audio-learning platform designed to help you review key topics and clinical vignettes while on the move. With the convenience of headphones, you can listen and learn as you go about your day—whether doing household chores, running errands or during your daily workout. This platform lets you make the most of small pockets of time, transforming mundane tasks into valuable learning opportunities.

Elevate your internal medicine knowledge without letting a busy schedule hold you back. Try AudioBoards today and enhance your ability to retain important information—one audio lesson at a time.

Our goal is to enhance understanding of medical principles while emphasizing that this content is for informational purposes only and not a substitute for professional clinical guidance. Tune in to expand your medical knowledge and stay informed about current trends in medicine! 

Send us Fan Mail

Welcome to Today’s Episode!

In this episode, we explore various esophageal conditions, including infectious esophagitis, pill-induced injury, eosinophilic esophagitis, and more. Tune in for key insights on diagnosis, treatment, and prevention strategies for these disorders.

Support the show

AudioBoards is an audio-learning platform designed to help you review key topics and clinical vignettes while on the move. With the convenience of headphones, you can listen and learn as you go about your day—whether doing household chores, running errands or during your daily workout. This platform lets you make the most of small pockets of time, transforming mundane tasks into valuable learning opportunities.

Elevate your internal medicine knowledge without letting a busy schedule hold you back. Try AudioBoards today and enhance your ability to retain important information—one audio lesson at a time.

Our goal is to enhance understanding of medical principles while emphasizing that this content is for informational purposes only and not a substitute for professional clinical guidance. Tune in to expand your medical knowledge and stay informed about current trends in medicine! 

Send us Fan Mail

Welcome to Today’s Episode!

In this episode, we’re diving into Acute Upper GI Bleeding—exploring the common causes, including peptic ulcers, esophageal varices, and portal hypertension. We’ll cover how to assess and stabilize patients, key diagnostic tools, and the latest treatment strategies to manage this life-threatening condition effectively.

Support the show

AudioBoards is an audio-learning platform designed to help you review key topics and clinical vignettes while on the move. With the convenience of headphones, you can listen and learn as you go about your day—whether doing household chores, running errands or during your daily workout. This platform lets you make the most of small pockets of time, transforming mundane tasks into valuable learning opportunities.

Elevate your internal medicine knowledge without letting a busy schedule hold you back. Try AudioBoards today and enhance your ability to retain important information—one audio lesson at a time.

Our goal is to enhance understanding of medical principles while emphasizing that this content is for informational purposes only and not a substitute for professional clinical guidance. Tune in to expand your medical knowledge and stay informed about current trends in medicine!