Nutrition and the Brain- Parks Flashcards
What is Beri-Beri?
a thiamine (B1) deficiency
What are complications of beriberi (thiamine deficiency B1)?
- wernicke encephalopathy
- cardiac dilation, high output failure
- weight loss
- peripheral neuropathy
- muscle wasting
- edema
What are the symptoms of Wernicke’s?
Ophthalmoplegia, cerebellar ataxia and mental impairment = CONFUSED and Disoriented and Indifferent. I think of as acute.
What is the pathology of Wernicke’s?
Foci of hemorrhage & necrosis in mamillary bodies and walls of 3rd, 4th ventricles
What are the symptoms of Wernicke-Korsakoff?
Memory of NEW events seriously impaired so these people may confabulate. Old memories OK.
What is the pathology of Wernicke-Korsakoff?
Very similar to Wernicke’s. May be prominent degeneration of the neurons the walls of the 4th ventricle and medial thalamic nuclei.
How do you diagnose Wernickes on a CT?
the mammillary bodies will be edematous and have increased blood flow/vascularity
In an acute case of Wernickes you can get (blank) in your mammilary bodies and you will die
hemorrhage
What do normal mammilary bodies look like?
they are gray -> filled with neurons
Wernicke-korsakoff is more of a (acute/chronic) disease
chronic
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
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)
Mamillary bodies affect your (blank)
memory
Where will you see wernickes encephalopathy?
- 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
What should you give a chronic alcoholic presenting with symptoms of wernicke’s encephalopathy?
Parental thiamine, IM or IV
What is paresthesia?
numbness or tingling
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.
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)
Where are you going to see B12 deficiency?
- pernicious anemia (ie atrophic gastritis)
- gastrectomy (for cancer of stomach, ulcers, etc)
- impaired malabsorption from intestines
- bariatric surgery for obestiy
- inadequate diet or vegetarianism
Why is a gastric sleeve surgery bad?
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
What is the most common complication of gastric bypass surgery?
vit B12 deficiency
How do you prevent Alzheimer’s?
- 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)
WHy is iron bad?
it can get into brain and create free radicals
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.
B-vitamin
