Nutritional Deficiency Flashcards
characterized by nystagmus, conjugate gaze palsies, ataxia of gait and mental confusion
Wernicke disease
is a mental disorder in which retentive memory is impaired out of proportion to all other cognitive functions in an otherwise alert and responsive patient
Korsakoff amnesic state
Korsakoff psychosis
there are common medical circwnstances in which a subclinical thiamine deficiency becomes manifest
carbohydrate load, intravenous glucose is given to a malnourished individual unbalanced intravenous hyperalimentation refeeding syndrome thyrotoxicosis hypomagnesemia
triad features of Wernicke
opthalmoplegia (with nystagmus)
ataxia
disturbances in mentation and consciousness
T/F
In Wernicke disease, in approximately one-third of cases, one component of the triad may be the sole manifestation of the disease.
True
Ocular abnormalities in Wernicke Disease
1) nystagmus that is both horizontal and vertical and mainly evoked by gaze; this is the most common feature
(2) weakness or paralysis of the lateral rectus muscles, and
(3) weakness or paralysis of conjugate gaze
Most Common ocular abnormality in Wernicke Disease
nystagmus
Next to nystagmus, common eye abnormality in Wernicke disease
lateral rectus weaknes
most common disturbance of mentation in Wernicke disease
global confusional state
Patients with the Korsakoff amnesic state may have a demonstrably impaired olfactory discrimination. This deficit is probably attributable to a lesion of
mediodorsal nucleus of thalamus and its connections
Acute lesions of Wernicke-Korsakoff as seen in MRI
The acute lesions of the Wernicke-Korsakoff syndrome in the mammillary bodies, and other medial thalamic and periaqueductal areas
Before treatment with thiamine, patients with Wernicke disease show a marked reduction in _________. Restoration of these values and of thiamine di-and triphosphate toward normal occurs within a few hours of the administration of thiamine, and completely normal values are usually attained within _____h.
transketolase, 24 hrs
True or False
The effect of thiamine is so constant that a failure of the nystagmus and ocular palsies to respond to it should raise doubts about the diagnosis of Wernicke disease.
True
In wernicke disease, treatment with thiamine
Horizontal nystagmus sometimes disappears in ______. Sixth-nerve palsies, ptosis, and vertical gaze palsies recover completely within a _______ in most cases, but vertical nystagmus may sometimes persist for ________.
horizontal nystagmus - minutes
sixth nerve palsies, ptosis and vertical gaze palsies - a week or two
vertical nystagmus - several months
patients with Wernicke disease have lesions in which parts of the brain
the paraventricular regions of the thalamus and hypothalamus, mammillary bodies,
periaqueductal region of the midbrain,
floor of the fourth ventricle (particularly in the regions of the dorsal motor nuclei of the vagus and vestibular nuclei),
and supenor cerebellar vermis
hypothermia in wernicke disease is attributed to which affected region of brain
to lesions in the posterior and posterolateral nuclei of the hypothalamus
why is magnesium being given when treating for wernicke disease
it acts as a cofactor for thiamine activity
the chronic alocholic exhausts thiamine in how many weeks
7-8 weeks
T/F
infantile wernicke -beriberi disease
affects only breastfed infants
True
usually in the 2nd to 5th months of life
where is thiamine absorbed
jejunum
Wernicke disease is a result of a deficiency of
thiamine
Fatalities in wernicke disease were attributable mainly to (2)
hepatic failure and infection
lesions responsible for the memory disorder - those seen in
thalami
predominantly parts of the medial dorsal nuclei
it is essentially a disease of the heart and of the peripheral nerves, with or without edema
nutritional polyneuropathy
neuropathic beriberi
