A 58-year-old man with known cirrhosis from hepatitis C presents with confusion, inverted sleep-wake cycle and asterixis. He is afebrile; blood glucos...

Question

A 58-year-old man with known cirrhosis from hepatitis C presents with confusion, inverted sleep-wake cycle and asterixis. He is afebrile; blood glucose and electrolytes are normal, and CT brain is unremarkable. What is the most appropriate initial pharmacological treatment?

Accepted Answer

Oral lactulose titrated to 2-3 soft bowel motions daily

Answer

Oral rifaximin alone

Answer

Intravenous mannitol

Answer

High-dose intravenous benzodiazepines

Answer

No specific therapy; reassure and observe

au-racp MCQ (SBA): Hepatic encephalopathy

A 58-year-old man with known cirrhosis from hepatitis C presents with confusion, inverted sleep-wake cycle and asterixis. He is afebrile; blood glucose and electrolytes are normal, and CT brain is unremarkable. What is the most appropriate initial pharmacological treatment?