is a symptom seen in hepatic encephalopathy that is characterized as a flapping tremor of the hand.
USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
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?