A 58 year old man with alcohol use disorder is brought to the hospital because of confusion and difficulty walking. On examination, he has horizontal nystagmus, impaired abduction of the right eye, and a broad based gait. He is given intravenous glucose before vitamin replacement, and his mental status worsens. Deficiency of which of the following cofactors most likely explains this patient's condition?
- A)Pyridoxal phosphate
- B)Biotin
- C)Thiamine pyrophosphateGABARITO
- D)Ascorbic acid
- E)Tetrahydrofolate
Explicação
This patient has Wernicke encephalopathy due to thiamine deficiency. Thiamine pyrophosphate is required for pyruvate dehydrogenase, alpha ketoglutarate dehydrogenase, branched chain alpha ketoacid dehydrogenase, and transketolase, so glucose loading can acutel... Ver explicação completa e trilha adaptativa →