Korsakoff's psychosis associated with chronic alcoholism is caused by the deficiency of?

DSSSB - 28 August 2019 (Shift-1)

Biochemistry & Nutrition

Easy

Appeared in: DSSSB - 28 August 2019 (Shift-1)

Explanation

Korsakoff syndrome is an amnestic disorder caused by a deficiency in thiamine (vitamin B1).
It is most commonly associated with the poor nutritional habits and impaired absorption found in individuals with chronic alcohol use disorder.
Thiamine is essential for carbohydrate metabolism and energy generation in the brain; its deficiency leads to neuronal damage, particularly in memory-related brain regions.
The syndrome often follows an episode of Wernicke's encephalopathy, which includes confusion, ataxia (unsteady gait), and ophthalmoplegia (eye muscle weakness).

Option B: Riboflavin (Vitamin B2) deficiency causes ariboflavinosis, characterized by symptoms like cheilosis (cracks at the corners of the mouth), glossitis (inflamed tongue), and seborrheic dermatitis, not Korsakoff's psychosis.
Option C: Biotin (Vitamin B7) deficiency is very rare and is not associated with Korsakoff's psychosis. Its deficiency can lead to dermatitis, hair loss, and neurological symptoms, but the clinical picture is distinct.
Option D: Niacin (Vitamin B3) deficiency causes pellagra, which is known for the 'three Ds': dermatitis, diarrhea, and dementia. While dementia is a symptom, the overall syndrome, including a characteristic rash, is different from Korsakoff's psychosis.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Nutritional Deficiencies in Chronic Alcoholism as background academic context rather than a clinical decision trigger.
Nurses must maintain a high index of suspicion for thiamine deficiency in patients with a history of chronic alcohol use, malnutrition, or hyperemesis gravidarum.
A critical nursing intervention is to administer thiamine BEFORE providing any glucose-containing intravenous fluids. Giving glucose first can exhaust the patient's limited thiamine reserves and precipitate acute Wernicke's encephalopathy.
What if? If a patient with chronic alcoholism is admitted for dehydration and is confused, the priority is not just fluid resuscitation but also immediate parenteral thiamine administration to prevent irreversible brain damage.

How to Approach the Question

First, identify the key terms in the question: 'Korsakoff's psychosis' and 'chronic alcoholism'.
Recall the common complications and nutritional deficiencies associated with chronic alcohol abuse.
Evaluate the options, which are all B vitamins. Access your knowledge about the specific deficiency disease linked to each vitamin.
Connect Korsakoff's psychosis, a known neurological complication of alcoholism, to its direct cause, which is thiamine (B1) deficiency.
Differentiate this from the deficiency syndromes of other B vitamins like Riboflavin (ariboflavinosis), Niacin (pellagra), and Biotin (rare dermatitis/neuropathy) to confirm the correct answer.

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 2 p. 510-512

E6 Medicine Davidson Principles Practice 24e p. 734-736

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 797-799