Physiological Adaptation Q 76

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Mr. Jay develops hepatic encephalopathy. Which clinical manifestation is most common with this condition?

  

     A. Increased urine output

     B. Altered level of consciousness

     C. Decreased tendon reflex

     D. Hypotension

    

    

Correct Answer: B. Altered level of consciousness

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Changes in behavior and level of consciousness are the first signs of hepatic encephalopathy. Hepatic encephalopathy is caused by liver failure and develops when the liver is unable to convert protein metabolic product ammonia to urea. This results in accumulation of ammonia and other toxic in the blood that damages the cells.

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Option A: The main cause of renal dysfunction in inpatients with liver disease is prerenal failure; specifically, the cause is a reduction in perfusion of the kidneys.

Option C: It must be emphasized that the flapping tremor of the extremities is also observed in patients with uremia, pulmonary insufficiency, and barbiturate toxicity.

Option D: A diseased liver can cause portal hypertension, which is high blood pressure in the portal vein. The portal vein supplies the liver with blood. Over time, this pressure causes blood vessels to grow, called collateral blood vessels. These vessels act as channels to divert the blood under high pressure.

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