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  1. #1
    BioPatel is offline Member
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    vitamin deficiency

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    A 9-year-old child in a developing country is brought to a clinic by his parents because he has trouble keeping up with his classmates on the playground. Physical examination is remarkable for pulmonary rales. Chest x-ray shows biventricular dilation of the heart. Deficiency of which of the following vitamins is the most likely cause of this child's condition ?

    A. Ascorbic acid
    B. Retinol
    C. Riboflavin
    D. Thiamine
    E. Vitamin K

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    D.

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    BioPatel is offline Member
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    The correct answer is D. Thiamine deficiency is most frequently encountered in alcoholics and in developing countries. Deficiency of this vitamin can take several forms: dilated cardiomyopathy (“wet beriberi ”), polyneuropathy (“dry beriberi”), and mamillary body degeneration (Wernicke-Korsakoff syndrome).
    Ascorbic acid (choice A, Vitamin C) deficiency causes scurvy, associated with capillary fragility, bony abnormalities, and poor wound healing.

    Retinol (choice B, Vitamin A) deficiency causes blindness and impaired immune responses.

    Riboflavin ( choice C) deficiency causes cheilosis, glossitis, and dermatitis.

    Vitamin K (choice E) deficiency causes impaired blood clotting because of decreased production of factors II, VII, IX, and X.

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    why do you give thiamine before giving glusose in alcoholic

    D. Thiamine . Alcoholic you give this vitamin first before you give glucose. Why?

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    Re: why do you give thiamine before giving glusose in alcoho

    Quote Originally Posted by Anonymous
    D. Thiamine . Alcoholic you give this vitamin first before you give glucose. Why?
    Wernicke-Korsakoff syndrome

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    causes of thiamine deficiency

    Causes:

    * Lack of thiamine intake

    o Diets consisting mainly of milled rice, which contains thiaminases

    o Alcoholic state

    o Starvation state

    * Increased consumption states

    o Diets high in carbohydrate or saturated fat intake

    o Pregnancy

    o Hyperthyroidism

    o Lactation

    o Fever

    o Increased physical exercise

    * Increased depletion

    o Diarrhea

    o Diuretic therapies

    o Peritoneal dialysis

    o Hemodialysis

    * Decreased absorption

    o Chronic intestinal disease

    o Alcoholism

    o Malnutrition

    o Folate deficiency

    + Thiamine serves as a coenzyme in a variety of metabolic processes as thiamine pyrophosphate. In these processes, thiamine pyrophosphate is regenerated via the donation of a proton from the reduced form of nicotinamide adenine dinucleotide (NADH).

    + Folic acid is essential to having enough dihydrofolate reductase to regenerate NADH from its oxidative form so that NADH continues to be present to regenerate thiamine pyrophosphate without being consumed in the process.

    + If folic acid is deficient in the cells, then it causes an indirect thiamine deficiency because thiamine is present but cannot be activated.

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    Asclepius1's Avatar
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    In an alcoholic why do you have to give thiamine before you give glucose? Please explain in detail.

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    usmle2007 is offline Newbie
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    Quote Originally Posted by ADOC
    In an alcoholic why do you have to give thiamine before you give glucose? Please explain in detail.
    I think I know the answer.

    Wernickoff is caused by a deficiency of Thiamine. In chronic alcoholics, their thiamine levels are very low and we know that deficiency of thiamine causes Wernickoff. Given carbohydrates to chronic alcoholics will deplete thiamine because the body will use up thiamine to covert carbohydrates to glucose. Therefore, this will throw an alcoholic from having very little thiamine to having none. Having none is deadly.

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    Thiamine is needed for PDH reaction in the brain to produce ATP. You need PDH to metabolize glucose to Acetyl CoA, if you do not produce Acetyl Coa, you do not produce enough ATP for brain function.

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    GFLIP's Avatar
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    give a banana bag:

    A banana bag is a bag of IV fluids containing multivitamins. The bags typically contain multivitamins, thiamine and folic acid, sometimes magnesium sulfate, and are usually used to replenish nutritional deficiencies or correct a chemical imbalance in the human body. Most
    often they are used for alcoholics who need thiamine to prevent Wernicke-Korsakoff syndrome.

    Multivitamins are yellow in color, which is what makes the fluid yellow, hence the term "banana bag". Banana bags are also known as "rally packs".

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