Question

A 59-year-old man with long-standing heavy alcohol use presents with confusion, asterixis and elevated serum ammonia. He has known cirrhosis and no evidence of intracranial pathology on CT. What is the most appropriate initial therapy for his encephalopathy?

Accepted Answer

Oral lactulose titrated to produce 2-3 soft stools per day

Answer

Intravenous mannitol

Answer

High-protein diet

Answer

Immediate liver transplantation

Answer

High-dose benzodiazepines to control agitation

Practice question

A 59-year-old man with long-standing heavy alcohol use presents with confusion, asterixis and elevated serum ammonia. He has known cirrhosis and no evidence of intracranial pathology on CT. What is the most appropriate initial therapy for his encephalopathy?