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Medicine

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Hematology

Question
16 out of 16
 



A
B
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Ans. B

Thiamine

1. Thiamine functions in the decarboxylation of α-ketoacid, such as pyruvate α-ketoglutarate, and branched-chain amino acids and thus is a source of energy generation.

2. In addition, thiamine pyrophosphate acts as a coenzyme for a transketolase reaction that mediates the conversion of hexose and pentose phosphates.

3. Causes:

a. Poor dietary intake.

b. Alcoholism (Alcohol interferes directly with the absorption of thiamine and with the synthesis of thiamine pyrophosphate.)

c. Chronic illness, such as cancer.

d. Prolonged hyperemesis gravidarum and anorexia,

e. Patients on chronic diuretic therapy due to increased urinary thiamine losses.

Prolonged thiamine deficiency causes beriberi (wet or dry), Wernicke's encephalopathy, Korsakoff psychosis.

Beriberi

1. Wet beriberi

a. Presents primarily with cardiovascular symptoms, due to impaired myocardial energy metabolism and dysautonomia, and can occur after 3 months of a thiamine-deficient diet.

b. Patients present with an enlarged heart, tachycardia,

c. High-output congestive heart failure, peripheral edema, and peripheral neuritis.

2. Dry beriberi

a. Present with a symmetric peripheral neuropathy of the motor and sensory systems with diminished reflexes.

b. The neuropathy affects the legs most markedly, and patients have difficulty rising from a squatting position.

i. Wernicke's encephalopathy, consisting of horizontal nystagmus, ophthalmoplegia (due to weakness of one or more extraocular muscles), cerebellar ataxia, and mental impairment.

ii. Korsakoff psychosis. When there is an additional loss of memory and a confabulatory psychosis, the syndrome is known as Wernicke-Korsakoff syndrome.

Extra Edge: Prolonged Thiamin (Vitamin B1) deficiency, Leads to lactic acidosis (AIIMS Nov 10)

Hematology Flashcard List

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