Parks: Nutritional Disorders

Question 1

Beri-beri means (blank). It is caused by a deficiency in (blank)

Answer 1

weak-weak; thiamine

Question 2

What vitamin is Thiamine?

Answer 2

Vit B1

Question 3

What are some symptoms of Wernicke’s syndrome?

Answer 3

ophthalmoplegia (eyes have trouble moving)
cerebellar ataxia
mental impairment

Question 4

What causes the symptoms of Wernicke’s encephalopathy?

Answer 4

foci of hemorrhage and necrosis in mamillary bodies and walls of 3rth and 4th ventricles

Question 5

What happens to your memory in Wernicke-Korsakoff syndrome? New memories? Old memories?

Answer 5

memory of new events is seriously impaired while old memories are OK

Question 6

How will you know the patient has opthalmoplegia?

Answer 6

you ask the patient to look to the left and look to the right - some eye muscles will not be working properly

Question 7

Mamillary bodies are associated with (blank)

Answer 7

Wernicke’s syndrome

Question 8

In an acute case of Wernicke’s syndrome, you can get (blank) in the mamillary bodies and in the thalamic nuclei

Answer 8

hemorrhage

Question 9

What disease occurs with thiamine deficiency?

Answer 9

Wernicke’s syndrome

Question 10

In Wernicke-Korsakoff syndrome, what happens to patients who have mamillary body damage and can’t form new memories?

Answer 10

confabulation

Question 11

In what clinical situations is this syndrome seen most frequently in the United States?

Answer 11

chronic alcoholics
gastric disorders - can’t eat (chronic gastritis, gastric carcinoma)
obesity surgery like gastric bypass
prisoner’s who are fed a poor diet

Question 12

How to treat Wernicke’s?

Answer 12

parenteral (IV or IM) thiamine

Question 13

Major causes of vitamin B12 deficiency

Answer 13

intestinal malabsorption and dietary deficiency (inadequate diet or vegetarianism)

*pernicious anemia and bariatric surgery, too

Question 14

What is parasthesia?

Answer 14

numbness, tingling - feeling of “pins and needles”

Question 15

painful parasthesis in both legs
impaired position sense and vibration sense
MCV elevated
»methylmalonic acid level

Answer 15

vit B12 deficiency

Question 16

Why do people with vit B12 deficiency have decreased joint position and vibrations sense?

Answer 16

problems with dorsal columns

Question 17

Why do you get neurological symptoms with Vit B12 deficiency?

Answer 17

In Vit B12 deficiency, demyelination of dorsal and lateral columns of the spinal cord occurs

**Vit B12 is necessary for the development of initial myelination of the spinal cord;

Question 18

What type of demyelinization do you get with Vit B12 deficiency?

Answer 18

COMBINED degeneration

**lateral AND dorsal columns

Question 19

Combined degeneration and de-myelinization

Answer 19

B12

Question 20

What are some problems with people who have surgery via the gastric sleeve and other bypass surgeries?

Answer 20

decreased B12 absorption bc decreased intrinsic factor release, leading to Wernicke’s encephalopathy

Question 21

What dietary factors can help prevent Alzheimer’s disease?

Answer 21

get Vit B12

if using multi-vitamin, don’t use vits with iron and copper (can cause oxidative damage)

Question 22

(blank) can slow the shrinkage of the whole brain and can be beneficial for Alzheimer’s pts

Answer 22

B-vitamin treatment