HEPATIC ENCEPHALOPATHY

Question 1

is the neuropsychiatric manifestation of hepatic failure associated with portal hypertension and the shunting of blood from the portal venous system into the system circulation.

Answer 1

Hepatic Encephalopathy

Question 2

initially the disease of hepatic encephalopathy was termed as

Answer 2

Subclinical or minimal hepatic encephalopathy

Question 3

is considered the major etiologic factor in the development of encephalopathy

Answer 3

Ammonia

Question 4

Ammonia enters the brain and excites what receptors?

Answer 4

Peripheral benzodiazepine-type receptors on astrocyte cells

Question 5

GABA

Answer 5

Gamma-aminobutyric Acid (GABA) neurotransmission

Question 6

causes depression of the central nervous system that inhibits neurotransmission and synaptic regulation

Answer 6

Gamma-aminobutyric Acide (GABA) Neurotransmission

Question 7

The largest source of Ammonia is the

Answer 7

enzymatic and bacterial digestion of dietary and blood proteins in the GI tract

Question 8

reduces the number of intestinal bacteria capable of converting urea to ammonia.

Answer 8

Antibiotic like neomycin sulfate

Question 9

are toxic metabolites of sulfur-containing compounds that excreted by the liver under normal conditions.

Answer 9

Mercaptans

Question 10

earliest symptoms of hepatic encephalopathy include

Answer 10

mental status changes and motor disturbances

Question 11

an involuntary flapping of the hands may be seen in stage II encephalopathy

Answer 11

Asterixis

Question 12

Inability to reproduce a simple figure in two or three dimensions is referred to as

Answer 12

construction apraxia

Question 13

a sweet, slightly fecal odors to the breath that is presumed to be of intestinal origin, may be noticed.

Answer 13

Fetor Hepaticus

Question 14

is given to reduce serum Ammonia levels.

Answer 14

Lactulose

Question 15

this indicates that lactulose is performing as intended.

Answer 15

Two or three soft stools

Question 16

lactulose can diluted wtih

Answer 16

fruit juice

Question 17

possible side effects of lactulose include

Answer 17

intestinal bloating and cramps, which usually disappear within a week.

Question 18

normal level of consciousness with period of lethargy and euphoria

Answer 18

Stage I

Question 19

Increased drowsiness; disorientation; inappropriate behavior

Answer 19

Stage II

Question 20

Stuporous; difficult to rouse; sleeps most of time

Answer 20

Stage III

Question 21

Comatose; may not respond to painful stimuli

Answer 21

Stage IV