thiamine deficiency.

[aspiringmd1015]

Can anyone just clear this up for me. is it Beri Beri, when its a nutritional deficiency(as in decreased intake) and is it WK syndrome when its only alcohol associated? mixing these two up, help!

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[deep582]

Wet beriberi refers to congestive heart failure
Dry beriberi refers to peripheral neuropathy

Wernicke's encephalopathy refers to the triad of ophthalmoplegia, ataxia, and confusion
Korsakoff syndrome refers to memory loss/psychosis
(You don't need to really know the distinction between these two tbh, just know that they stem from the same etiology)

ALL of these are manifestations of thiamine deficiency.
As you know, alcoholics are particularly prone to having thiamine deficiency due to poor diets and interference of thiamine absorption due to alcoholic gastritis. Likewise, alcoholics with thiamine deficiency can manifest as any of the above clinical pictures. Indeed, Wernicke-Korsakoff tends to be much more closely associated with alcoholism, though EtOH use is not necessary for diagnosis. I would presume that alcoholics are more prone to the CNS manifestations of thiamine deficiency due to a superimposed alcoholic encephalopathy, though this is just my conjecture.

Hope this helps

 

[zhopv10]

^nice, nothing to add to those. I'll just add a side note that sometimes helps me remember what systems get messed up. Thiamine def depletes ATP due to it being a cofactors of dehydrogenase enzymes. So it effects highly aerobic tissues/organs like the heart, brain, nerves etc. that's always why glucose infusion makes it worse (use up more ATP bringing in glucose and turning it to G6P etc.)


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[aspiringmd1015]

so if i have a dietary thiamine deficiency, i can have wet, or Dry beri beri, as well as WK syndrome? as well as me being an alcoholic, i can have wet and dry beri beri?

 

[zhopv10]

They are all just associated with low thiamine so anything that causes that can lead to those syndromes (most commonly an alcoholic). I'm not sure if there is a spectrum of severity I thought the korsakoff was irreversible whereas the wernicke's was (or maybe vice versa cant remember)


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[aspiringmd1015]

i think i recall the goljan audio lectures saying something like, if its a dietary deficiency its labeled as beri beri?

 

[deep582]

They are all dietary deficiencies....
It is labeled as beriberi vs wernicke korsakoff depending on what organ is affected....

 

[zhopv10]

^yup what deep said (it's broken down as he wrote earlier)


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[chillaxbro]

Wernicke = acute
Korsakoff = chronic

Remember it by the order of the names

 

[zhopv10]

^nice, there we go, knew I had it backwards haha I like the name memory aid


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[Transposony]

Or just remember Korsacoff = Kronic ( Corsacoff=Chronic) and "the other one is the other one" .
As Goljan said "just remember one" and "the other one is the other one". That way there can be no confusion!

 

[zhopv10]

Haha one of the classic goljanisms I still can't keep straight which vasculitis is p-ANCA + even tho that's the example he used for that


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[Transposony]

I still can't keep straight which vasculitis is p-ANCA + even tho that's the example he used for that

I kinda remember it backwards -- c in c-ANCA stands for Cyclophosphamide which is the drug of choice for Wegener's
.................................................................................................................................... and "the other one is the other one" !

 

[zhopv10]

Haha ya I think that one has the best shot of sticking but it still leaves me, that may be one that finds its way onto my "dump sheet"


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