Mental deterioration can occur due to the deficiency of?

UPRVUNL - 2021

Applied Nutrition & Dietetics

Easy

Appeared in: UPRVUNL - 2021

Explanation

Thiamine (Vitamin B1) is crucial for glucose metabolism in the brain. Its deficiency impairs neuronal function, leading to cell death.
Severe thiamine deficiency causes Wernicke-Korsakoff syndrome, a condition defined by significant mental deterioration, including confusion, severe memory loss, and psychosis.
This condition is most frequently observed in patients with chronic alcoholism, as alcohol impairs thiamine absorption and storage.
Early symptoms of thiamine deficiency can be nonspecific, such as irritability and a decrease in short-term memory, but can progress to profound and permanent dementia if untreated.

Option A: Deficiency of Ascorbic acid (Vitamin C) causes scurvy. While fatigue and irritability can occur, its primary symptoms are physical, such as bleeding gums, joint pain, and poor wound healing, not severe mental deterioration.
Option B: Vitamin D deficiency primarily affects bone health, leading to rickets in children and osteomalacia in adults. Its main symptoms are skeletal pain, deformities, and muscle weakness, not cognitive decline.
Option D: Pyridoxine (Vitamin B6) deficiency can cause neurological symptoms like peripheral neuropathy, seizures, depression, and confusion. However, it does not typically cause the profound global mental deterioration and amnesia characteristic of Wernicke-Korsakoff syndrome.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain The concept tested is the relationship between specific vitamin deficiencies and their resulting health conditions, with a focus on neurological symptoms like mental deterioration as background academic context rather than a clinical decision trigger.
Nurses must maintain a high index of suspicion for thiamine deficiency in at-risk populations, particularly patients with a history of alcohol use disorder, malnutrition, hyperemesis gravidarum, or post-bariatric surgery.
It is a critical patient-safety measure to administer thiamine BEFORE giving glucose-containing intravenous fluids to a malnourished or alcoholic patient. Giving glucose first can precipitate acute Wernicke's encephalopathy by rapidly depleting the last reserves of thiamine.
What if? If a patient with a history of alcoholism presented with confusion, ataxia, and nystagmus (involuntary eye movements), the nurse's priority action would be to anticipate and prepare for the immediate intravenous administration of thiamine, as this is a medical emergency.

How to Approach the Question

First, identify the key phrase in the question: "mental deterioration". This points to a condition affecting cognitive function.
Next, review the options, which are all vitamins. The task is to link one of these vitamins to a deficiency state that causes significant cognitive decline.
Recall or deduce the primary deficiency disease for each vitamin. Ascorbic acid -> Scurvy; Vitamin D -> Rickets/Osteomalacia; Thiamine -> Beriberi/Wernicke-Korsakoff; Pyridoxine -> Neuropathy/Anemia.
Compare the hallmark symptoms of these diseases. Wernicke-Korsakoff syndrome, caused by thiamine deficiency, is uniquely characterized by severe mental deterioration, confusion, and memory loss.
Eliminate the other options because their primary deficiency symptoms are physical (scurvy, rickets) or involve different neurological symptoms (peripheral neuropathy from B6 deficiency) rather than global mental deterioration.
Conclude that thiamine is the most fitting answer.

Concept Tested & Keywords

Concept Tested: The concept tested is the relationship between specific vitamin deficiencies and their resulting health conditions, with a focus on neurological symptoms like mental deterioration.
Stem keywords: Mental deterioration, deficiency
Lead-in keywords: BEST, MOST RELEVANT CLUE
Negative lead-in flag: false

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E6 Medicine Harrison 22e Part 2 pp. 511-513, 510-512, 1388-1390