DSSSB 12 August 2024
Mental Health Nursing
Easy
Which is the alcohol-induced amnestic disorder?
Appeared in: DSSSB 12 August 2024
Explanation
- Wernicke's syndrome is an acute neurological emergency caused by severe thiamine (Vitamin B1) deficiency, a common complication of chronic alcohol abuse.
- It represents the acute phase of Wernicke-Korsakoff syndrome, which is the classic alcohol-induced amnestic (memory loss) disorder.
- The syndrome presents with a characteristic triad of symptoms: confusion, ataxia (unsteady gait), and ophthalmoplegia (abnormal eye movements).
- Prompt treatment with high-dose thiamine is crucial to prevent progression to Korsakoff's syndrome, a chronic and often irreversible state of profound amnesia.
Why Other Options Were Wrong
- Option A: Alcohol hallucinosis is a psychotic disorder, not an amnestic disorder. It is characterized by hallucinations (typically auditory) that occur in the context of heavy drinking or withdrawal, but with a clear sensorium (the patient is not delirious).
- Option C: Peripheral neuropathy is damage to the peripheral nerves, typically causing pain, numbness, or weakness in the hands and feet. While it is a common neurological complication of chronic alcoholism, it is not a central nervous system disorder characterized by memory loss.
- Option D: Delirium tremens (DTs) is a severe, life-threatening form of alcohol withdrawal. It is characterized by delirium (severe confusion), agitation, fever, and autonomic hyperactivity (e.g., tachycardia, hypertension). While it involves altered mental status, it is an acute withdrawal state, not a primary amnestic disorder.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Alcohol-Related Neurological and Psychiatric Disorders as background academic context rather than a clinical decision trigger.
- Nurses must recognize the triad of Wernicke's symptoms (confusion, ataxia, eye problems) in patients with a history of alcohol abuse as a medical emergency.
- Immediate intervention involves administering high-dose parenteral (IV or IM) thiamine. CRITICAL: Thiamine must be given before any glucose-containing IV fluids, as glucose can worsen the condition by rapidly depleting the body's remaining thiamine stores.
- What if? If a patient with suspected Wernicke's is only given an IV drip with dextrose (glucose) without prior thiamine, their neurological symptoms can acutely worsen, precipitating irreversible brain damage and accelerating the progression to Korsakoff's syndrome.
How to Approach the Question
- First, identify the key terms in the question: 'alcohol-induced' and 'amnestic disorder'.
- Understand that 'amnestic' refers to amnesia, which is a significant loss of memory.
- Evaluate each option to determine which one is primarily characterized by memory impairment.
- Eliminate 'Alcohol hallucinosis' as it's a psychotic disorder (hallucinations).
- Eliminate 'Peripheral neuropathy' as it affects nerves in the limbs, not central memory functions.
- Eliminate 'Delirium tremens' as it's an acute withdrawal state of delirium, not a primary memory disorder.
Concept Tested & Keywords
- Concept Tested: Alcohol-Related Neurological and Psychiatric Disorders
- Stem keywords: alcohol-induced, amnestic disorder
- Lead-in keywords: Which is
Question ID
Q5hC_h5WWwMYq227ZpBzj
Reference Book
E6 Medicine Davidson Principles Practice 24e p. 1214-1216
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 893-895
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 4236-4238
Practise the full DSSSB 12 August 2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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