TY - CHAP M1 - Book, Section TI - Chapter 44. Portal Systemic Encephalopathy & Hepatic Encephalopathy A1 - Greenberger, Norton J. A2 - Greenberger, Norton J. A2 - Blumberg, Richard S. A2 - Burakoff, Robert Y1 - 2012 N1 - T2 - CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 2e AB - Diagnosis 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 - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/04/19 UR - accessmedicine.mhmedical.com/content.aspx?aid=55961222 ER -