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FINAL THIAMINE.pptx
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- 2. QUE: A 59YR OLD MALE IS BROUGHT TO THE EMERGENCY DEPARTMENT IN AN EXTREMELY CONFUSED AND DISORIENTED ,WITH AN UNSTEADY GAIT.THE PATIENT HAS BEEN KNOWN IN THE PAST FOR HEAVY DRINKER.ON EXAMINATION HE IS AFEBRILE WITH A NORMAL BLOOD PRESSURE.HE IS EXTREMELY DISORIENTED AND AGITATED.HORIZONTAL RAPID EYE MOVEMENT ON LATERAL GAZE IS NOTED BILLATERALLY.HIS GAIT IS VERY UNSTEADY. INVESTIGATIONS:URINE DRUG SCREEN WAS NEGATIVE AND HAD A POSITIVE LOOD ALCOHOL LEVEL.WHAT IS THE PROBABLE DIAGNOSIS?
- 3. 3 MISNOMER THYMINE IS PRESENTIN DNA THIAMINE IS PRESENT IN VITAMIN B1
- 4. ALEURONE LAYER OFCEREALS WHOLE WHEAT FLOUR AND UNPOLISHED HAND POUND RICE YEAST MEAT NUTS GREEN VEGETABLES SOURCE
- 5. “ STRUCTURE OF THIAMINE ITCONTAINS A SUBSTITUTED PYRIMIDINE RING CONNECTED TO A SUBSTITUTED THIAZOLE BY MEANS OF METHYLENE BRIDGE. IT IS IN INACTIVE FORM IT IS CONVERTED TO ACTIVE FORM BY ADDITION OF 2 PHOSPHATE BY ATP IN PRESENCE OF ENZ.TPP TRANSFERASE TO FORM TPP (ACTIVE FORM) 5
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- 7. 7 METABOLISM ABSORBED IN SMALLINTESTINE BY ACTIVE TRANSPORT IF ALLOWANCE IS 5MG/DAY IF EXCEEDED MORE THAN 5 MG/DAY PASSIVE DIFFUSION CONTRIBUTES
- 8. PHOSPHORYLATION TAKES PLACE ATJEJENUM TO YIELD TPP THIAMINE IS CARRIED BY PORTAL VEIN TO LIVER 8
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- 12. BRANCHED CHAIN ALPHAKETO ACID DEHYDROGENASE 12 VALINE TPP SUCCINYL COA
- 13. 13 IN ABSENCE OFTHIAMINE PYRUVATE IS CONVERTED TO LACTIC ACID LEADIND TO LACTIC ACIDOSIS
- 14. 14 RDA NUTRITIONAL RESEARCH COUNCIL INSISTSTO TAKE ABOUT 1.0 - 1.5 MG FOR ADULT IN TERMS OF ENERGY 0.4MG/1000KCAL FOR MALE – 1.2MG/DAY FOR FEMALE– 1.1MG/DAY CHILD – 0.5MG/DAY
- 15. 15 DEFICIENCY MANIFESTATIONS BERI BERI OVERALL PICTUREOF THIAMINE DEFICIENCY LEADS TO……
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- 17. CARDIOVASCULAR DISEASES 17 PALPATION ANDRISE IN HEART BEAT ENLARGEMENT OF LIVER DILATION CARDIAC FAILURE EDEMA
- 18. CARDIAC FAILURE ● THIAMINE DEFICIENCY 18 FAILUREIN CARB.METAOLISM ATP LEVEL DECRESES DEMAND FOR O2 INCREASES PALPATION AND TRACHYCARDIA CARDIOMEGALY EDEMA
- 19. CARDIAC FAILURE CAUSESCYANOSIS WHICH LEADS TO BLUE IN COLOUR 19
- 20. “ ● NEUROLOGIGAL DISEASES ● ANXIETY ●MENTAL CONFUSION ● WERNICKE’S ENCEPHALOPATHY ● PERIPHERAL NEURITIS 20
- 21. 21 DECREASED AVAIL OFACETYL COA AND NADPH DECREASE IN ACETYL CHOLINE MENTAL DISSORDER
- 22. GI MANIFESTATIONS IMPAIRED CELLFN LEADS TO IMPAIRED DIGESTION LEADS TO CONSTIPATION AND ANOREXIA
- 23. 23 TYPES OF BERIBERI WET BERI BERI DRY BERI BERI INFANTILE BERI BERI
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- 27. 27 WERNICKE SYNDROME CEREBRAL BERIBERI ENCEPHALOPATHY (OPTHALMOPLEGIA,,NYSTAGMUS, CEREBRAL ATAXIA)
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- 30. QUE: A 59YR OLD MALE IS BROUGHT TO THE EMERGENCY DEPARTMENT IN AN EXTREMELY CONFUSED AND DISORIENTED ,WITH AN UNSTEADY GAIT.THE PATIENT HAS BEEN KNOWN IN THE PAST FOR HEAVY DRINKER.ON EXAMINATION HE IS AFEBRILE WITH A NORMAL BLOOD PRESSURE.HE IS EXTREMELY DISORIENTED AND AGITATED.HORIZONTAL RAPID EYE MOVEMENT ON LATERAL GAZE IS NOTED BILLATERALLY.HIS GAIT IS VERY UNSTEADY. INVESTIGATIONS:URINE DRUG SCREEN WAS NEGATIVE AND HAD A POSITIVE BLOOD ALCOHOL LEVEL.WHAT IS THE PROBABLE DIAGNOSIS?
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