RT Book, Section A1 Greenberger, Norton J. A2 Greenberger, Norton J. A2 Blumberg, Richard S. A2 Burakoff, Robert SR Print(0) ID 55961222 T1 Chapter 44. Portal Systemic Encephalopathy & Hepatic Encephalopathy T2 CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 2e YR 2012 FD 2012 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-176848-1 LK accessmedicine.mhmedical.com/content.aspx?aid=55961222 RD 2024/03/28 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.