hepatic encephalopathy Flashcards
1
Q
due to
A
excess absorption ammonia + glutamine from bacterial breakdown of proteins in gut
2
Q
features
A
confusion, alt GCS
asterix
constructional aprazia
triphasic slow waves on ECG
raised ammonia
3
Q
Grade I
A
irritablitity
4
Q
Grade II
A
confusion, inappropriate behaviour
5
Q
Grade III
A
incoherent ,
restless
6
Q
Grade IV
A
coma
7
Q
precipitating factors
A
infection GI bleed post TIPSS constipation sedatives, diuretics hypokalaemia renal failure inc dietary protein
8
Q
secondary prophylaxis
A
lactulose, with addition of rifaximin
