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KPSC Staff Nurse - 2016
Mental Health Nursing
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Korsakoff's psychosis is due to intake of?

Appeared in: KPSC Staff Nurse - 2016

Explanation

  • Korsakoff's psychosis is a chronic neurological disorder caused by a severe deficiency of thiamine (vitamin B1).
  • The most common cause of this thiamine deficiency in developed countries is chronic, heavy alcohol consumption.
  • Alcohol interferes with the absorption, storage, and utilization of thiamine from the diet, leading to brain damage.
  • The condition often follows an acute, reversible phase known as Wernicke's encephalopathy; together they are called Wernicke-Korsakoff syndrome.
  • The hallmark symptoms of Korsakoff's are severe anterograde amnesia (inability to form new memories) and confabulation (inventing memories to fill gaps).

Why Other Options Were Wrong

  • Option A: While cannabis can impair short-term memory and cognition, it does not cause the specific pattern of brain damage (e.g., to mammillary bodies) or the profound, permanent amnesic syndrome characteristic of Korsakoff's psychosis.
  • Option B: Opium and other opioids are central nervous system depressants. Their primary toxic effects include respiratory depression, sedation, and miosis (pinpoint pupils). They are not associated with thiamine deficiency or Korsakoff's syndrome.
  • Option C: Amphetamines are central nervous system stimulants. Chronic high-dose use can lead to a 'stimulant psychosis,' which is characterized by paranoia, delusions, and hallucinations, but not the severe amnesia and confabulation seen in Korsakoff's syndrome.

Related Visual

Visual explanation — Related Visual
Clinical Relevance
  • Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology of Korsakoff's Psychosis as background academic context rather than a clinical decision trigger.
  • Wernicke-Korsakoff syndrome is a neurological emergency. Nurses must recognize the signs of acute Wernicke's encephalopathy (confusion, ataxia, ophthalmoplegia) in at-risk patients to facilitate immediate treatment and prevent irreversible brain damage.
  • A critical nursing safety measure is to administer parenteral thiamine before giving any glucose-containing IV fluids to a malnourished patient with a history of alcohol abuse. Giving glucose first can deplete the last reserves of thiamine and precipitate or worsen the encephalopathy.
  • What if? If a patient with a history of alcohol abuse presents with only confusion and an unsteady gait, but no eye movement problems, the nurse should still suspect acute Wernicke's encephalopathy. The full triad of symptoms is not always present, and immediate thiamine administration is still the priority.
How to Approach the Question
  • First, identify the key term in the question: 'Korsakoff's psychosis'.
  • This is a factual recall question that tests your knowledge of the neurological complications associated with substance abuse.
  • Access your knowledge base regarding the long-term effects of different substances.
  • Recall that Korsakoff's psychosis is specifically linked to a deficiency of thiamine (vitamin B1), which is most commonly caused by chronic, heavy alcohol consumption.
  • Systematically evaluate the other options. Rule out cannabis, opium, and amphetamine by recalling their primary effects and recognizing that they do not cause this specific amnesic syndrome.
  • Confirm that alcohol is the well-established primary cause of the thiamine deficiency that leads to Korsakoff's psychosis.
Concept Tested & Keywords
  • Concept Tested: Etiology of Korsakoff's Psychosis
  • Stem keywords: Korsakoff's psychosis, intake
  • Lead-in keywords: BEST, MOST RELEVANT CLUE
  • Negative lead-in flag: false

Question ID

Q8pRALKZnGbNpQrs7hFH3E

Reference Book

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 4236-4238, 4170-4172

E6 Medicine Davidson Principles Practice 24e p. 1215-1217

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