A man with chronic alcohol dependence is admitted with confusion, ataxia and ophthalmoplegia. What should be given before any glucose infusion?
Answer and explanation
Correct answer: C. Intravenous high-potency B vitamins with thiamine
- Step 1: The triad suggests Wernicke encephalopathy from thiamine deficiency. Step 2. Glucose metabolism consumes thiamine, so giving glucose first can precipitate or worsen the encephalopathy, and parenteral thiamine is given first. Answer: Intravenous high-potency B vitamins with thiamine. Why not the others: Folic acid does not treat the neurological syndrome. Vitamin K corrects clotting not encephalopathy. Naloxone has no role without opioid toxicity.
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