A 52 year old man with severe alcohol use disorder is brought to the emergency department because of confusion and unsteady gait. Examination shows horizontal nystagmus and bilateral lateral rectus weakness. He is given intravenous dextrose before vitamin supplementation and becomes more disoriented. Deficiency of which cofactor most likely underlies this syndrome?
- A)Biotin
- B)Folate
- C)Pyridoxine
- D)ThiamineGABARITO
- E)Niacin
Explicação
Thiamine is correct. Wernicke encephalopathy causes the triad of confusion, ophthalmoplegia, and ataxia due to vitamin B1 deficiency, especially in chronic alcohol use disorder or malnutrition. Administering glucose before thiamine can worsen symptoms because ... Ver explicação completa e trilha adaptativa →