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Old 08-06-2012
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Default A 68-year-old homeless man is in an alcoholic stupor when...

A 68-year-old homeless man is in an alcoholic stupor when he is brought to the emergency department. After “drying out,” he shows signs of severe retrograde amnesia. He exaggerates wildly about his living conditions, which he describes as luxurious. His in vitro red blood cell transketolase level rises 35% after thiamine diphosphate is added to the culture. A lesion in which of the following is the most likely cause of these findings?

a) Amygdaloid nuclei
b) Dorsomedial nucleus
c) Habenular nuclei
d) Nucleus accumbens
e) Nucleus basalis of Meynert
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Old 08-06-2012
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Default

B
Thiamine deficiency in alcoholics results in degeneration of
-Dorsomedial nucleus of thalamus
-hippocampus
-mamillary bodies
-anterior vermis of cerebellum
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Old 08-06-2012
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Default correct answer

yup, the answer is b) Dorsomedial nucleus

This patient has Korsakoff psychosis, which is characterized by retrograde memory loss, the inability to form new memories, and a tendency for confabulation (exaggerating) to compensate for these losses. It is caused by thiamine deficiency and commonly accompanies chronic alcoholism. Thiamine is a coenzyme for transketolase, which participates in the pentose monophosphate pathway of glucose metabolism. A thiamine deficiency is indicated by a change in erythrocyte transketolase activity. If enzyme activity increases by > 15% when thiamine diphosphate is added to the culture medium, then the thiamine deficiency is considered significant enough to indicate Korsakoff psychosis.
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