RT Book, Section
A1 Greenberger, Norton J.
A2 Greenberger, Norton J.
A2 Blumberg, Richard S.
A2 Burakoff, Robert
SR Print(0)
ID 1119990691
T1 Portal Systemic Encephalopathy & Hepatic Encephalopathy
T2 CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 3e
YR 2016
FD 2016
PB McGraw-Hill Education
PP New York, NY
SN 9780071837729
LK accessmedicine.mhmedical.com/content.aspx?aid=1119990691
RD 2024/04/18
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.