Nutrition and the Brain- Parks

Question 1

What is Beri-Beri?

Answer 1

a thiamine (B1) deficiency

Question 2

What are complications of beriberi (thiamine deficiency B1)?

Answer 2

• wernicke encephalopathy
• cardiac dilation, high output failure
• weight loss
• peripheral neuropathy
• muscle wasting
• edema

Question 3

What are the symptoms of Wernicke’s?

Answer 3

Ophthalmoplegia, cerebellar ataxia and mental impairment = CONFUSED and Disoriented and Indifferent. I think of as acute.

Question 4

What is the pathology of Wernicke’s?

Answer 4

Foci of hemorrhage & necrosis in mamillary bodies and walls of 3rd, 4th ventricles

Question 5

What are the symptoms of Wernicke-Korsakoff?

Answer 5

Memory of NEW events seriously impaired so these people may confabulate. Old memories OK.

Question 6

What is the pathology of Wernicke-Korsakoff?

Answer 6

Very similar to Wernicke’s. May be prominent degeneration of the neurons the walls of the 4th ventricle and medial thalamic nuclei.

Question 7

How do you diagnose Wernickes on a CT?

Answer 7

the mammillary bodies will be edematous and have increased blood flow/vascularity

Question 8

In an acute case of Wernickes you can get (blank) in your mammilary bodies and you will die

Answer 8

hemorrhage

Question 9

What do normal mammilary bodies look like?

Answer 9

they are gray -> filled with neurons

Question 10

Wernicke-korsakoff is more of a (acute/chronic) disease

Answer 10

chronic

Question 11

What is this:
People have been drinking a long time then stop, their brain will heal in a weird way and they are unable to remember anything new, so they will start making up new memories that are super strange

Answer 11

Wernicke-Korsakoff

(this is a clinical term, so the path lab will always label this just as wernicke and the physician will have to decide whether its korsakoff)

Question 12

Mamillary bodies affect your (blank)

Answer 12

memory

Question 13

Where will you see wernickes encephalopathy?

Answer 13

• Chronic alcoholic (alcohol impairs absorption of thiamine)
• Gastric disorders such a chronic gastritis, gastric carcinoma, persistent emesis
• Obesity surgery (gastric bypass)
• Prisoner’s who are fed a poor diet

Question 14

What should you give a chronic alcoholic presenting with symptoms of wernicke’s encephalopathy?

Answer 14

Parental thiamine, IM or IV

Question 15

What is paresthesia?

Answer 15

numbness or tingling

Question 16

What is this:
patient has painful paresthesis in both legs for past 18 months. Patient has impaired position sense and vibration sense. B12 levels are border line. MCV was slightly high. The methylmalonic acid level is extremely high and homocysteine is highly elevated.

Answer 16

Her posterior columns and lateral columns of her spinal cord were damaged due to her B12 deficiency.

This is called COMBINED degeneration due to demyelination (lack of B12)

(because B12 helps with myelination, and without it you will result in demyelination)

Question 17

Where are you going to see B12 deficiency?

Answer 17

• pernicious anemia (ie atrophic gastritis)
• gastrectomy (for cancer of stomach, ulcers, etc)
• impaired malabsorption from intestines
• bariatric surgery for obestiy
• inadequate diet or vegetarianism

Question 18

Why is a gastric sleeve surgery bad?

Answer 18

because you remove the fundus which has parietal cells. Since parietal cells make intrinsic factor and you lose this, then you will get B12 deficiency

Question 19

What is the most common complication of gastric bypass surgery?

Answer 19

vit B12 deficiency

Question 20

How do you prevent Alzheimer’s?

Answer 20

• min intake of saturate fats and transf fat
• vegetales, legumes, fruits, whole grains (replace meats and dairy products)
• Vit E from food (15 mg per day)
• Vit B12
• Dont eat use a multivitamin with iron or copper
• aerobic exercise
• minimize aluminum (maybe)

Question 21

WHy is iron bad?

Answer 21

it can get into brain and create free radicals

Question 22

In a study about alzheimers they found that (Blank) supplementation could slow the atrophy of specific brain regions that are key components of alzheimer’s disease process and that are associated with cognitive decline.

Answer 22

B-vitamin