Hepatic Encephalopathy Flashcards
1
Q
What is it?
A
Confusion due to liver disease (liver failure)
2
Q
How is it graded?
A
1-4:
1 = mild confusion
4 = coma
3
Q
Does only alcoholic cirrhosis cause it?
A
Not unique to alcohol caused liver disease: caused by anything that causes liver failure
4
Q
What are the precipitants?
A
GI bleed Infection Constipation Dehydration Medication esp. sedation
5
Q
What are some associated signs?
A
Foetor hepaticus
Flap (asterixis) = flapping tremor
6
Q
What should be excluded?
A
Infection
Hypoglycaemia
Intracranial bleed
i.e. there are other reasons why someone could be unconscious
7
Q
How should it be managed?
A
Treat underlying cause
Repeated admission with HE is an indicator for liver transplant
Bowel clear out, lactulose, enemas (these are laxatives)
Antibiotics
Supportive: ITU, airway support, nasogastric tube for meds
