TY - CHAP M1 - Book, Section TI - Portal Systemic Encephalopathy & Hepatic Encephalopathy A1 - Greenberger, Norton J. A2 - Greenberger, Norton J. A2 - Blumberg, Richard S. A2 - Burakoff, Robert PY - 2016 T2 - CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 3e AB - ESSENTIALS OF DIAGNOSISDiagnosis can often be made during physical examination by checking for fetor hepaticus and asterixis, and evaluating mental status using serial 7’s and the “A” deletion test.Precipitating factors include gastrointestinal bleeding, sepsis, azotemia, sedative or analgesic use, and noncompliance with medications.Consider other causes (eg, infections, intracranial bleeding, metabolic abnormalities), in patients with known cirrhosis and prior evidence of portal system encephalopathy who present with altered mental status.Mental changes in patients with subclinical or minimal hepatic encephalopathy can impair automobile handling skills; patients and their families should be advised of this risk. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accessmedicine.mhmedical.com/content.aspx?aid=1119990691 ER -