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Old 04-18-2010
Seetal's Avatar
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Question 50 yo man with short term memory loss

A 50-year-old man with a history of alcoholism has difficulty with short-term memory. He is unable to recall the date and cannot remember what he ate for breakfast this morning. He thinks the examiner is a long-lost friend and carries on a conversation with the examiner as if they have known each other for years. His long-term memory appears intact. The patient dies shortly thereafter of a myocardial infarct. Pathological examination of his brain is most likely to disclose an abnormality involving which of the following?

(A) Amygdala
(B) Caudate nucleus
(C) Hippocampus
(D) Locus caeruleus
(E) Mammillary bodies
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Old 04-18-2010
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This is another classic hand-in-hand correlation, at least for the USMLE. Alcohol causes thiamine deficiency, in the context of which the mammillary bodies are primarily affected (correct answer is E).

By the way, I would like to apologize about sth... This question just dug some rotten knowledge out from the most innersome depths of my hippocampus! The pathologic damage that is evident in alcoholics with Wernicke encephalopathy is actually located in the mammillary bodies. Sorry, Dr. Seetal, for the inaccurate information in my previous post!
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Old 04-18-2010
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Quote:
Originally Posted by ath.pantelis View Post
This is another classic hand-in-hand correlation, at least for the USMLE. Alcohol causes thiamine deficiency, in the context of which the mammillary bodies are primarily affected (correct answer is E).

By the way, I would like to apologize about sth... This question just dug some rotten knowledge out from the most innersome depths of my hippocampus! The pathologic damage that is evident in alcoholics with Wernicke encephalopathy is actually located in the mammillary bodies. Sorry, Dr. Seetal, for the inaccurate information in my previous post!
thanks for the explanation. oh yeah... i did have a question regarding alcohol and gait (if they were located at the cerebellar hemisphere)

ok so mammilary bodies (Wernicke's E) is related to thiamine def and alcoholic gait may still be related to the cerebellum?
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Old 04-18-2010
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Ok, let's sum up... A potential pathologic exam of the CNS of a person with Wernicke's encephalopathy would reveal damage to the following structures:
- mammillary bodies
- nuclei of CN III, IV, VI, VIII (--> ophthalomoplegia)
- dorsal nucleus of V
- cerebellar vermis
- thalamus, hypothalamus & periaqueductal gray matter.

You may cross check the above information through Google (or whichever search engine).
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