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On examination in emergency department, 32 yr old male has an unsteady gait, mild B/L oculoparesis and spider angiomas. He is confused and agitated. Which of the following agents is the best immediate pharmacological treatment?
A. Anticoagulants
B. AChE inhibitor
C. Pentobarbital
D. Salicylates
E. Thiamine
 

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I think the presence of "spider angiomas" is the only clue which points towards a liver cirrhosis.

If u combine this symptom with other neurological symptoms the pt has.... u can rule out the other options and u r left with Thiamine only.
 
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Wernicke-Korsakoff Syndrome

Thiamine Deficiency in Alcoholics:

----------Triad of Confusion + Ataxia + Ophthalmoplegia (Wernicke traid)
----------Memory loss and confabulation (Korsakoff part)

This patient exhibits Wernicke triad.
 
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