Question

A 62-year-old man with cirrhosis presents with new onset confusion, asterixis, and disorientation. There is no focal neurological deficit. Serum ammonia is elevated. What is the most appropriate first-line therapy for his encephalopathy?

Accepted Answer

Oral lactulose titrated to 2-3 soft stools per day

Answer

High-dose IV corticosteroids

Answer

Antipsychotics only

Answer

Prophylactic broad-spectrum antibiotics only

Answer

Restrict protein intake to zero

Practice question

A 62-year-old man with cirrhosis presents with new onset confusion, asterixis, and disorientation. There is no focal neurological deficit. Serum ammonia is elevated. What is the most appropriate first-line therapy for his encephalopathy?