cirus
Forum Guru
Topics: 108
Posts: 740
|
24) A 31-year-old homeless woman is brought to the emergency department after being found face down on the street. The woman has a long history of admissions to the hospital for alcohol-related issues, including seizures, withdrawal, and hallucinations. Today, she was seen to fall in the street, have what were described as "convulsions" and then vomit. She remained face down in the street until the paramedics arrived. On physical examination, she has dry mucous membranes, a jugular venous pressure of less than 5 cm, and diffuse ecchymoses on her face, body, and breasts. Which of the following vitamins should be administered prior to volume resuscitation with IV fluids containing glucose?
A. Vitamin B1 (Thiamin)
B. Vitamin B3 (Niacin)
C. Vitamin B12 (Cobalamin)
D. Vitamin C
E. Vitamin K
|
| khorshid
Forum Guru
Topics: 32
Posts: 591
|
A (B1)
|
| doc_clotaire
Forum Guru
Topics: 159
Posts: 1,265
|
A. Vitamin B1 (Thiamin) ------------to prevent Wernicle korsackoff Sd
___________________
The elevator to succes is broke ,you must take the stairs
|
| dr in trouble
Forum Guru
Topics: 62
Posts: 602
|
vit B1
___________________
If u want to do something, do it today as there is no tomorrow.
|
| Justice
Forum Fanatic
Topics: 117
Posts: 2,324
|
A. Vitamin B1 (Thiamin)
___________________
Don't live in a town where there are no doctors
|
| cirus
Forum Guru
Topics: 108
Posts: 740
|
|
| cirus
Forum Guru
Topics: 108
Posts: 740
|
The correct answer is
A. Administering glucose to a patient who is deficient in thiamin may precipitate Wernicke-Korsakoff syndrome, which is a combination of confusion, ataxia, ophthalmoplegia, anterograde and retrograde amnesia, and confabulation. It is therefore imperative to administer IV thiamin prior to glucose-containing IV fluids.
Niacin (choice B) is an essential component of the coenzymes involved in oxidation-reduction reactions. Profound deficiency in niacin causes the classic triad of pellagra: dermatitis, diarrhea, and dementia.
Vitamin B12 deficiency (choice C) may lead to megaloblastic anemia, neurologic complications, and dementia.
Vitamin C deficiency (choice D) may lead to difficulty with wound healing and scurvy.
Vitamin K (choice E) is essential for the production of selected clotting factors. Although alcoholics may be deficient in all the vitamins mentioned in the answer choices, only deficits in thiamin are associated with harmful effects if glucose is administered without replenishment.
|
|
| |
| | | | | | | |
