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Psychiatry General 63da65a1

Wernicke's encephalopathy can be prevented by:

A
IV saline
B
Large amounts of glucose
C
Thiamine supplement
D
Imipramine
High-Yield Explanation
C. i.e. Thiamine supplement The patient is having Wernicke's disease (chronic alcoholism, ataxia, opthalmoplegia) Wernicke's DiseaseIt is a common & preventable disorder occurring Wt deficiency of thiamineQ, most commonly associated with poor nutritional habits of people with chronic alcohol abuseQ. But other causes of malnutrition eg starvation, hyperemesis gravidarum, prolonged intravenous hyperalimentation, gastric placation (surgery), gastric carcinoma, hemodialysis, cancer & AIDS can cause thiamine deficiency.Thiamine is a cofactor of transketolase, pyruvate dehydrogenase & a-keto glutarate dehydrogenase. So its deficiency produces a diffuse decrease in cerebral glucose utilization (I/ t mitochondrial damage) and glutamate accumulation resulting in excitotoxic damage. Pathologically periventricular (i.e. around 3rd -4th ventricle & aqueduct) lesions with petechial hemorrhages (in acute cases) and atrophy of mamillary body (in chronic cases) is seen. Amnesia is related to lesions in dorsal medial nuclei of thalamus, or medial temporal lobe (hippocampus & coex).

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