Topic: Korsakoff's Psychosis
Subject: Medicine
In a patient with recent onset of alcohol amnestic disorder, the mental status test most likely to be done poorly is memory of:

Korsakoff's psychosis (Korsakoff's/alcoholic amnestic syndrome) occurs in 80% of untreated patients with Wernicke's encephalopathy. A severe or repeated attack of postalcoholic delirium tremens can trigger Korsakoff's psychosis whether or not a typical attack of Wernicke's encephalopathy has occurred first. Immediate memory is severely affected (best tested with '3 items for 5mins'); retrograde and anterograde amnesia occurs in varying degrees. Patients tend to draw on memory of remote events, which appears to be less affected than memory of recent events. Disorientation to time is common. Emotional changes are common; they include apathy, blandness, or mild euphoria with little or no response to events, even frightening ones. Spontaneity and initiative may be decreased. Confabulation is often a striking early feature; bewildered patients unconsciously fabricate imaginary or confused accounts of events they cannot recall; these fabrications may be so convincing that the underlying disorder is not detected.