Q:

A 46 year old man who is a heavy drinker is brought to the emergency department in a drowsy state. He is responding vaguely to questions. Examination: nystagmus and hyperreflexia. MCV 103fl. What is the most likely cause for his cognitive impairment?

waelhammad
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2022-11-03
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A 46 year old man who is a heavy drinker is brought to the emergency department in a drowsy state. He is responding vaguely to questions. Examination: nystagmus and hyperreflexia. MCV 103fl. What is the most likely cause for his cognitive impairment?

  1. B1 deficiency
  2. B12 deficiency
  3. Folate deficiency
  4. B6 deficiency
  5. Alcohol withdrawal
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waelhammad
2022-11-03
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The key is A. B1 deficiency. [Presence of confusion and nystagmus indicates Wernicke’s encephalopathy caused by thiamin (vit. B1) deficiency].

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