Psychotherapy: 91b - Neurology and Nutrition

Ataxia

Abnormal eye movements

• What is pellagra?

  What are the signs?

  Pellagra = Niacin (B3) deficiency

  Dermatitis, Diarrhea, Dementia

  • Methotrexate is associated with what deficiency?

    Folate (B9)

  What is the appearance of Wernicke’s encephalopathy on MRI?

  Medial thalami and mamillary body hyperintensity

  What are the symptoms of pyridoxine (B6) deficiency

  
  Sensory polyneuropathy

  Often caused by treatmetn with isoniazid

  Dermatitis, dementia, and diarrhea are signs of which vitamin deficiency?

  Niacin (B3) deficiency

  What is the treatment for cobalamin (B12) deficiency?

  B12 supplementation for life

  Isoniazid is associated with which deficiency?

  Pyridoxine (B6)

  How is thiamine deficiency treated?

  Give thiamine (B1) before or concurrently with glucose

  • Giving ...

  Mamillary body hyperintensity is pathognomonic for which deficiency?

  Thiamine deficiency

  However, imaging will more commonly show hyperintensity of the medi...

  Which syndrome is associated with cobalmin (B12) deficiency?

  What are the symptoms?

  Subacute combined degeneration

  • Affects corticospinal and dorsal column

  ...

  Which labs should be checked in a patient with suspected cobalamin (B12) deficiency?

  • Serum B12
    

    • <100 will have neurological symptoms

  Which syndromes may be caused by thiamine (B1) deficiency?

  • 
    Wernicke-Korsakoff
    

    • Ataxia, confusion, abnormal eye movements

  Deficiency of which vitamin is associated with subacute combined degeneration?

  Describe the symtoms

  Cobalamin (B12) deficiency)

  • Weakness

  • ...

  High levels of which compounds indicate intracellular cobalamin (B12) deficiency?

  Homocysteine

  Methylmalonic acid

  May indicate cobalamin...

  View all 15 terms

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  Psychotherapy: 91b - Neurology and Nutrition

  Term	Definition
  What are the signs of Wernicke’s Encephalopathy? What is it caused by?	Ataxia Abnormal eye movements Nystagmus Confusion Caused by thiamine deficiency - treat with thiamine to prevent Korsakoff symptoms! (Amnesia, confabulation, peripheral neruopathy)
  What is pellagra? What are the signs?	Pellagra = Niacin (B3) deficiency Dermatitis, Diarrhea, Dementia Often seen in people who have malnourishment + alcohol use disorder Often in underdeveloped countries
  Methotrexate is associated with what deficiency?	Folate (B9)
  What is the appearance of Wernicke’s encephalopathy on MRI?	Medial thalami and mamillary body hyperintensity
  What are the symptoms of pyridoxine (B6) deficiency	Sensory polyneuropathy Often caused by treatmetn with isoniazid
  Dermatitis, dementia, and diarrhea are signs of which vitamin deficiency?	Niacin (B3) deficiency
  What is the treatment for cobalamin (B12) deficiency?	B12 supplementation for life
  Isoniazid is associated with which deficiency?	Pyridoxine (B6)
  How is thiamine deficiency treated?	Give thiamine (B1) before or concurrently with glucose Giving glucose before thiamine will make thiamine deficiency worse, because thiamine is needed to metabolize glucose
  Mamillary body hyperintensity is pathognomonic for which deficiency?	Thiamine deficiency However, imaging will more commonly show hyperintensity of the medial thalami May also see hyperintensity in the periaqueductal grey
  Which syndrome is associated with cobalmin (B12) deficiency? What are the symptoms?	Subacute combined degeneration Affects corticospinal and dorsal column Mild weakness Paresthesias Ataxic paraplegia Unsteadiness, stiffness/weakness in legs Cognitive changes Irritability, apathy, somnolence Scotoma Irritable, unsteady, pins and needles, blind spot
  Which labs should be checked in a patient with suspected cobalamin (B12) deficiency?	Serum B12 <100 will have neurological symptoms <200 needs further eval even w/o symtpoms 200-300 may still be deficient Homocysteine If high => intracellular B12 deficiency Methylmalonic acid If high => intracellular B12 deficiency Antibody to IF Megaloblastic anemia
  Which syndromes may be caused by thiamine (B1) deficiency?	Wernicke-Korsakoff Ataxia, confusion, abnormal eye movements Followed by psychosis (amnesia, confabulation) and neuropathy Beri Beri Length-dependent peripheral polyneuropathy +/- edema
  Deficiency of which vitamin is associated with subacute combined degeneration? Describe the symtoms	Cobalamin (B12) deficiency) Weakness Paresthesia Gait unsteadiness, stiffness/weakness in legs Irritability, apathy, somnolence Scotoma
  High levels of which compounds indicate intracellular cobalamin (B12) deficiency?	Homocysteine Methylmalonic acid May indicate cobalamin deficiency even if cobalamin levels are normal