A 62-year-old man with known cirrhosis due to hepatitis C presents with confusion and asterixis. There is no focal neurological deficit. Serum ammonia...

Question

A 62-year-old man with known cirrhosis due to hepatitis C presents with confusion and asterixis. There is no focal neurological deficit. Serum ammonia is mildly elevated, and infection and intracranial pathology have been excluded. According to guideline-based management of hepatic encephalopathy, which treatment is most appropriate first-line?

Accepted Answer

Oral lactulose titrated to 2-3 soft stools per day

Answer

Intravenous mannitol

Answer

High-protein diet with protein supplements

Answer

Prophylactic broad-spectrum intravenous antibiotics only

Answer

Immediate intubation and hyperventilation

ca-mccqe1 MCQ (SBA): Hepatic encephalopathy