Systemic pathology: Wernicke encephalopathy: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Systemic pathology: Wernicke encephalopathy

Sample item

A 48-year-old chronic alcoholic is confused and ataxic and has nystagmus with ophthalmoplegia. He dies, and the brain is examined. Which lesion is found?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Haemorrhagic necrosis of the mammillary bodies

Wernicke encephalopathy is due to thiamine deficiency and causes petechial haemorrhage and necrosis of the mammillary bodies and periventricular and periaqueductal grey matter. Korsakoff psychosis (amnesia and confabulation) follows with damage to the dorsomedial thalamus.

Option by option

  • A. Atrophy of the caudate nucleus

    Caudate atrophy is characteristic of Huntington disease.

  • B. Neuronal loss in the hippocampal CA1 region

    CA1 neuron loss follows global hypoxia-ischaemia.

  • C. Depigmentation of the substantia nigra

    Substantia nigra depigmentation is the lesion of Parkinson disease.

  • D. Haemorrhagic necrosis of the mammillary bodies (correct)

    Correct. Thiamine deficiency injures the mammillary bodies and periventricular grey matter.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is D, Haemorrhagic necrosis of the mammillary bodies. Wernicke encephalopathy is due to thiamine deficiency and causes petechial haemorrhage and necrosis of the mammillary bodies and periventricular and periaqueductal grey matter.

Why is "Atrophy of the caudate nucleus" not the answer?

Caudate atrophy is characteristic of Huntington disease.

Why is "Neuronal loss in the hippocampal CA1 region" not the answer?

CA1 neuron loss follows global hypoxia-ischaemia.

Why is "Depigmentation of the substantia nigra" not the answer?

Substantia nigra depigmentation is the lesion of Parkinson disease.

What concept does this question test?

It tests Systemic pathology: Wernicke encephalopathy in Pathology. Korsakoff psychosis (amnesia and confabulation) follows with damage to the dorsomedial thalamus.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Systemic pathology: Wernicke encephalopathy?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.