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Life-threatening acidosis in an alcoholic - and in a hunger striker given intravenous glucose

Objectives

By the end of this exercise you should be able to:

Explain how thiamin deficiency leads to (potentially life-threatening) acidosis with elevated plasma concentrations of lactate and pyruvate

Describe the reactions catalysed by the pyruvate dehydrogenase multi-enzyme complex and the role of thiamin diphosphate

Describe a simple functional test of thiamin nutritional status