STEP 2: BECAUSE I GOT HIGH Flashcards
(27 cards)
Uncomplicated alcohol withdrawal tends to present with…
tremors, anxiety, restlessness, headache, nausea, and diaphoresis
TCA overdose
confusion, delerium, cardiac arrythmias, hypotension and anticholinergic toxicity.
How do we treat alcohol withdrawal?
Benzos
What is Wernicke encephalopathy?
An acute, reversible condition caused by severe thiamine (vitamin B1) deficiency
What are the causes of Wernicke encephalopathy?
Caused by severe thiamine deficiency due to:
* Chronic heavy alcohol use
* Inadequate intake
* Malabsorption
* Increased demand
* Increased loss
What is the classical triad of symptoms in Wernicke encephalopathy?
Confusion, oculomotor dysfunction, gait ataxia
What may chronic thiamine deficiency progress to?
Korsakoff syndrome
What are the key characteristics of Korsakoff syndrome?
Irreversible personality changes, anterograde and retrograde amnesia, confabulation
How is Wernicke encephalopathy diagnosed?
Clinically, but laboratory tests and brain imaging may be used in ambiguous cases
What is the treatment for Wernicke encephalopathy?
Immediate high-dose IV thiamine therapy followed by long-term thiamine supplementation
True or False: Wernicke encephalopathy is an emergency condition.
True
What are common symptoms of Wernicke encephalopathy?
Confusion, oculomotor dysfunction, gait ataxia, autonomic dysfunction, peripheral neuropathy, cardiovascular dysfunction
What is the active form of thiamine?
Thiamine pyrophosphate (TPP)
What occurs in the brain due to thiamine deficiency?
Decreased cerebral glucose metabolism and mitochondrial dysfunction
What are the long-term effects of thiamine deficiency in Korsakoff syndrome?
Permanent damage to limbic system components, leading to memory loss and emotional processing disruption
What laboratory tests can indicate thiamine deficiency?
↓ Serum thiamine levels, ↓ Erythrocyte transketolase activity, ↑ Serum lactate and pyruvate
What imaging findings may be present in Wernicke encephalopathy?
T2-weighted hyperintense lesions in the mammillary bodies and other brain areas
What is the prognosis for Wernicke encephalopathy if treated accordingly?
Generally good
What is the prognosis for Korsakoff syndrome?
Generally poor
What is confabulation?
Patients produce fabricated memories to fill in lapses of memory
What is Wernicke’s COAT mnemonic?
Confusion, Oculomotor dysfunction, Ataxia, Thiamine administration
What is Korsakoff’s CART mnemonic?
Confabulation, Anterograde and Retrograde amnesia, altered Temper
What should be avoided before administering IV glucose in Wernicke encephalopathy?
Thiamine must be administered before IV glucose infusions
Fill in the blank: Wernicke encephalopathy is caused by _______ deficiency.
thiamine (vitamin B1)
