Hepatic encephalopathy

Summary of Hepatic encephalopathy
Hepatic encephalopathy is the occurrence of confusion, altered level of consciousness, and coma as a result of liver failure; mainly its inability to metabolize ammonia to urea. It may ultimately lead to death. Treatment generally includes lactulose (increase NH4+ generation) and rifaximin or neomycin (decrease NH4+ producing gut bacteria).

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Pathology

Gastrointestinal system

Peritoneum and peritoneal cavity disorders
Upper gastrointestinal tract disorders
Lower gastrointestinal tract disorders
Liver, gallbladder and pancreas disorders
Gastrointestinal system pathology review

Assessments
Hepatic encephalopathy

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High Yield Notes
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Hepatic encephalopathy

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Preview

is a symptom seen in hepatic encephalopathy that is characterized as a flapping tremor of the hand.

Questions

USMLE® Step 1 style questions USMLE

2 questions

USMLE® Step 2 style questions USMLE

3 questions
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 A 56-year-old man comes to the emergency department because of a 2-day history of excessive somnolence. His medical history is relevant for being recently diagnosed with cirrhosis, in addition to having chronic alcoholism, and type I diabetes mellitus. He currently takes metformin and disulfiram. Upon further interrogation, the patient claims that his symptoms worsened after having a few steaks for his anniversary dinner a few days ago. The physical exam shows hyperreflexia and flapping of extended wrists. His temperature is 36.5°C (97.6°F), pulse is 50/min, respirations are 24/min, blood pressure is 130/70 mmHg.   Which of the following is the most appropriate initial treatment for this patient?

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