A 46-Year-Old Man Is Admitted to the Hospital for Atypical

A 46-year-old man is admitted to the hospital for atypical chest pain.  His medical history is significant for hypertension controlled with amlodipine and hypercholesterolemia treated with atorvastatin; he has a family history of depression and heart disease.  During review of his substance use history, the patient says that he has been a "regular drinker" for the last 5 years.  He drinks a 6-pack of beer every night and has 2 more beers in the morning to help him "get through the day."  He also admits to smoking marijuana occasionally but does not use tobacco or other illicit drugs.  Which of the following symptoms or signs is most likely to appear earliest during this patient's hospitalization?

A) Fluctuating arousal level
B) Hypersomnolence
C) Nystagmus
D) Tonic-clonic seizures
E) Tremulousness
F) Visual hallucinations

Correct Answer:

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