MEDizzy - You are called to the emergency room (ER) to admit a patient

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Enzymes and Biochemistry of Digestion

You are called to the emergency room (ER) to admit a patient to the medicine service. The patient appears malnourished and suffers from alcoholism. These are chronic issues, but there is an acute change that resulted in him being brought to the ER by the life squad. The patient is exhibiting some ataxia and increased confusion and has new-onset short-term memory loss. Besides eliciting the above on examination, you note that he also has a lateral rectus muscle palsy. Which one of the following statements is correct concerning this patient’s condition?

ExplanationThis patient has the classic symptoms of Wernicke encephalopathy, which results from an inadequate intake or absorption of thiamine. The patient is thus thiamine deficient. Within the United States, the condition is most often observed in chronic alcoholics with poor diets. Thiamine pyrophosphate is a required coenzyme for the oxidative decarboxylation of pyruvate and a-ketoglutarate during energy metabolism. The absence of thiamine leads to reduced energy production by all organs and tissues. Treatment includes intravenous thiamine, magnesium, and glucose and is reversible in the acute setting. The reduction in neuronal energy metabolism is not based on a type of enzyme inhibition (such as competitive, noncompetitive, or irreversible), but on the lack of a required cofactor for two enzymes.