Question at position 37 Wernicke-Korsakoff syndrome is characterized by involuntary movement and paralysis of the eyes, poor muscle coordination, confusion and short-term memory loss, and is often seen in alcoholics. Deficiency of what vitamin causes Wernicke-Korsakoff syndrome?Pantothenic acid (B5)Biotin (B7)Thiamine (B1)Riboflavin (B2)Niacin (B3)单项选择题
A
Pantothenic acid (B5)
B
Biotin (B7)
C
Thiamine (B1)
D
Riboflavin (B2)
E
Niacin (B3)

Question

Question at position 37 Wernicke-Korsakoff syndrome is characterized by involuntary movement and paralysis of the eyes, poor muscle coordination, confusion and short-term memory loss, and is often seen in alcoholics. Deficiency of what vitamin causes Wernicke-Korsakoff syndrome?Pantothenic acid (B5)Biotin (B7)Thiamine (B1)Riboflavin (B2)Niacin (B3)单项选择题

A

Pantothenic acid (B5)

B

Biotin (B7)

C

Thiamine (B1)

D

Riboflavin (B2)

E

Niacin (B3)

BlackTom AI · Accepted Answer

Thiamine (vitamin B1) deficiency causes Wernicke-Korsakoff syndrome because thiamine is an essential cofactor for key enzymes in cerebral energy metabolism; its loss produces the characteristic ophthalmoplegia, ataxia, confusion and memory impairment.

1. Relevant knowledge points and concepts
- Thiamine (B1) is a cofactor for pyruvate dehydrogenase, α‑ketoglutarate dehydrogenase, and transketolase. These enzymes are critical for ATP production via the Krebs cycle and the pentose phosphate pathway, especially in high‑energy tissues like the brain.
- Wernicke encephalopathy (acute) and Korsakoff syndrome (chronic amnestic state) are classically due to thiamine deficiency, often in alcoholics because of poor intake, malabsorption, impaired hepatic storage and altered phosphorylation of thiamine.
- Pathology commonly involves hemorrhagic lesions in mammillary bodies, medial thalami and periaqueductal gray, producing ophthalmoplegia, ataxia and confusional states; persistent damage yields anterograde amnesia and confabulation (Korsakoff).

2. Step-by-step reasoning
- The clinical triad (ophthalmoplegia/involuntary eye movements, ataxia/poor coordination, confusion) plus short‑term memory loss matches Wernicke encephalopathy progressing to Korsakoff.
- Because thiamine is required for brain glucose metabolism, its deficiency selectively injures vulnerable brain regions, explaining these neurological signs.
- Alcoholism is a common predisposing condition for thiamine deficiency, linking the clinical vignette to B1 deficiency.

3. Calculations
- Not applicable; biochemical pathways and clinical correlations are used instead.

4. Why the correct answer is correct
- Loss of thiamine impairs transketolase and dehydrogenase reactions, causing neuronal energy failure and the specific hemorrhagic lesions that produce the described signs. Improvement with thiamine administration and diagnostic rise in RBC transketolase activity after thiamine support this mechanism.

5. Why other options are incorrect
- Pantothenic acid (B5): deficiency is rare and causes nonspecific symptoms (fatigue, paresthesia), not Wernicke‑Korsakoff.
- Biotin (B7): deficiency causes dermatitis, alopecia, and peripheral neuropathy, not the classic ocular/amnestic syndrome.
- Riboflavin (B2): causes cheilosis, stomatitis, and seborrheic dermatitis when deficient.
- Niacin (B3): causes pellagra (dermatitis, diarrhea, dementia) with a different clinical picture.

6. Conclusion
The correct answer is Thiamine (B1), which matches the provided answer.

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