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Health Differences Across the Lifespan 2 Study Guide o Special training programs leading to certification for all levels of education (RN, LPN, CNA); consistent staffing patterns with stable personnel assignments 2.4 Wernicke Korsakoff Syndrome This is associated with chronic alcoholics, but also impacts those with brain tumors, head trauma, prolonged infections, metal poisonings, and pellagra. Wernicke–Korsakoff syndrome (also called wet brain, Korsakoff's psychosis, alcoholic encephalopathy, Wernicke's disease, and encephalopathy) is a manifestation of thiamine (vitamin B1) deficiency, or beriberi. This is usually secondary to alcohol abuse. It mainly causes vision changes, ataxia and impaired memory. Wernicke's encephalopathy is characterized by: • Confusion • Nystagmus (involuntary eyemovement) • Ophthalmoplegia (impaired eyemovement) • Anisocoria (unequal size of pupils) • Ataxia (lack of muscle coordination) • Sluggish pupillary reflexes • Coma and death if untreated Korsakoff's psychosis is characterized by: • Anterograde amnesia (inability to form newmemories) • Retrograde amnesia (loss of existing memories) • Confabulation (false perceptions ormemories) • Hallucinations Treatment: Add thiamine in the diet. Treatment for major withdrawal of alcohol would include assessing for fluid volume deficit and encouraging fluids to 3000 ml/day. Provide vitamin B complex, especially thiamin, and provide PRN medication like Librium or Ativan for exacerbationof symptoms. 2.5 Pellagra Pellagra is a vitamin deficiency disease most commonly caused by a chronic lack of niacin (vitamin B3) in the diet. It can be caused by a decreased intake of niacin or tryptophan, and possibly by excessive intake of leucine. It may also result from alterations in proteinmetabolism in disorders such as carcinoid syndrome. A deficiency of the amino acid lysine can lead to a deficiency of niacin as well. Pellagra is classically described by "the four D's": diarrhea, dermatitis, dementia, and death. Additional symptoms include: • High sensitivity to sunlight • Aggression

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