Hepatic Encephalopathy Learning Objectives

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Questions and Answers

What is the primary cause of hepatic encephalopathy in patients with cirrhosis?

  • Activation of benzodiazepine receptors in the brain
  • Accumulation of neurotransmitters in the CNS
  • Increased ammonia levels in the blood (correct)
  • Brain edema due to liver insufficiency

Which type of hepatic encephalopathy is associated with acute liver failure?

  • Type C
  • Type D
  • Type A (correct)
  • Type B

How is hepatic encephalopathy typically diagnosed?

  • CT scan of the brain revealing structural abnormalities
  • EEG showing normal brain activity
  • Presence of specific symptoms such as headache and fever
  • Blood ammonia levels (high sensitivity and specificity) (correct)

According to the West Haven Criteria, which grade of hepatic encephalopathy is characterized by somnolence and severe confusion?

<p>Grade III (A)</p>
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What is the first-line treatment approach for hepatic encephalopathy?

<p>Medication to reduce blood ammonia levels (B)</p>
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What is the classification system based on the underlying cause of hepatic encephalopathy?

<p>None of the above (D)</p>
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What is a common cause of altered mental status (AMS) in patients with infection/sepsis?

<p>Medications like sedatives and opioids (D)</p>
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How does lactulose help in hepatic encephalopathy?

<p>It prevents ammonia reabsorption into blood/CNS by donating a proton (D)</p>
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What is the role of Flumazenil in the treatment of hepatic encephalopathy?

<p>It is considered unethical (C)</p>
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Why is long-term use of Metronidazole not recommended for hepatic encephalopathy?

<p>It can cause peripheral neuropathy as a toxicity (C)</p>
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What is the purpose of combining lactulose with antibiotics in the treatment of hepatic encephalopathy?

<p>For short-term relief if nonresponsive to either agent alone (B)</p>
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What dietary modification can be considered to manage hepatic encephalopathy?

<p>Limiting protein intake to 10-20g/day with a maximum of 0.8-1g/kg/day (D)</p>
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