Cirrhosis Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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A 54-year-old woman is brought to the emergency department by her partner due to altered mental status for the last 2 days. According to her husband, the patient has become increasingly lethargic, disoriented, and agitated. The patient has a history of chronic hepatitis C infection that was diagnosed 14 years ago. She refused all treatment at that time. Temperature is 37.0°C (98.6°F), pulse is 98/min, and blood pressure is 104/74 mmHg. On examination, the patient is lethargic and oriented only to self. When her hands are outstretched in front of her and extended at the wrist, they exhibit a flapping tremor. The abdomen is nontender and mildly distended; shifting dullness to percussion is present. There is no nuchal rigidity. Stool occult blood is positive. Laboratory testing reveals the following findings:

A table lists laboratory values and results, including Sodium 130 mmol/L, Total bilirubin 3.2 mg/dL, Direct bilirubin 2.9 mg/dL, Alkaline phosphatase 90 U/L, AST 117 U/L, and ALT 105 U/L.

The patient is started on emergent therapy for her symptoms. Which of the following best explains the pathophysiology of this patient’s current condition?

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