Substance use: Wernicke encephalopathy: practice question

A Psychiatry 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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Psychiatry · Substance use: Wernicke encephalopathy

Sample item

A malnourished alcoholic presents with confusion, nystagmus, bilateral lateral rectus palsy and a wide-based gait. What should be given first?

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

The answer and the reasoning

A. Intravenous thiamine before glucose

Wernicke encephalopathy is a triad of ophthalmoplegia, ataxia and confusion due to thiamine deficiency. Parenteral thiamine is given before or with glucose, since glucose alone can deplete remaining thiamine and precipitate worsening.

Option by option

  • A. Intravenous thiamine before glucose (correct)

    Correct. Thiamine should precede glucose.

  • B. Oral folic acid only

    Folic acid alone does not reverse the condition.

  • C. Intravenous glucose before thiamine

    Glucose first can worsen the encephalopathy.

  • D. Haloperidol

    Antipsychotics are not the treatment.

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 Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Intravenous thiamine before glucose. Wernicke encephalopathy is a triad of ophthalmoplegia, ataxia and confusion due to thiamine deficiency.

Why is "Oral folic acid only" not the answer?

Folic acid alone does not reverse the condition.

Why is "Intravenous glucose before thiamine" not the answer?

Glucose first can worsen the encephalopathy.

Why is "Haloperidol" not the answer?

Antipsychotics are not the treatment.

What concept does this question test?

It tests Substance use: Wernicke encephalopathy in Psychiatry. Parenteral thiamine is given before or with glucose, since glucose alone can deplete remaining thiamine and precipitate worsening.

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 Substance use: Wernicke encephalopathy?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry 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.