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Chapter 8: Vitamins and Minerals

You are tending to a patient in the emergency room (ER) who presents with the following symptoms: nystagmus, organic toxic psychosis, and ataxia. You notice that the patient is dirty and appears not to have bathed in several days or weeks. There is an odor of vomit and alcohol on his clothing. Given the outward appearance and observed symptoms, your diagnosis is indicative of a deficiency in which of the following vitamins?

A. biotin

B. folate

C. pantothenate

D. riboflavin

E. thiamin

Answer E: The symptoms observed in this patient are typical of Wernicke-Korsakoff syndrome. This disease is most commonly found in chronic alcoholics due to their poor dietetic lifestyles. Wernicke-Korsakoff syndrome is characterized by the symptoms described as well as acute encephalopathy followed by chronic impairment of short-term memory. Persons afflicted with Wernicke-Korsakoff syndrome appear to have an inborn error of metabolism that is clinically important only when the diet is inadequate in thiamin.

Wernicke encephalopathy results from a deficiency of vitamin B1. Which of the following represents classical symptoms associated with this disorder?

A. megaloblastic anemia

B. nausea, peripheral neuropathy, mental depression, ophthalmoplegia

C. numbness, tingling, weakness, sore smooth tongue, anorexia, diarrhea, pallor of the skin and mucous membranes

D. seizure disorders

E. weight loss, diarrhea, dementia, and dermatitis

Answer B: Wernicke encephalopathy is most commonly found in chronic alcoholics due to their poor dietetic lifestyles. Wernicke encephalopathy is a syndrome characterized by ataxia, ophthalmoplegia, nystagmus, and confusion. If the disorder is left untreated, it will progress to Wernicke-Korsakoff syndrome which includes impairment of short-term memory, psychosis, coma, and eventually death.

A 60-year-old chronic smoker and alcoholic man suffering from odynophagia, insomnia, epigastric discomfort, and recurrent diarrhea presented to the outpatient department. Clinical examination revealed memory disorientation, stomatitis, glossitis, esophagitis, and exfoliative dermatitis with some vesicles on erythematous bases on photoexposed sites such as his hands shown in the attached image. These signs and symptoms are most likely the result of a deficiency in which of the following vitamins?


A. biotin

B. cobalamin

C. niacin

D. riboflavin

E. thiamin

Answer C: A diet ...

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