In the context of withdrawal syndromes, which feature is associated with delirium tremens?

• A. Autonomic instability that occurs later in withdrawal.
• B. Immediate seizure at last drink onset.
• C. Occurs only with acute drunkenness.
• D. No autonomic symptoms.

Answer: (D)

Delirium tremens is defined by autonomic hyperactivity that appears after stopping alcohol, during a later stage of withdrawal. You’ll typically see a combination of rapid heart rate, high blood pressure, fever, sweating, tremors, agitation, and confusion. This autonomic instability arises after a latent withdrawal period (not during intoxication and not as an immediate seizure at the last drink). The other options describe scenarios that don’t fit DT: seizures can occur in withdrawal but are not the defining feature of delirium tremens, it isn’t limited to acute drunkenness, and it certainly isn’t missing autonomic symptoms.