Bolded answer = said in office hours Yellow highlight = getting more detail Cirrhosis- 7 questions ● What is the best confirmatory test to diagnose cirrhosis? ○ Liver biopsy is the gold standard ● What are physical exam findings for hepatic encephalopathy? ○ Hepatic encephalopathy is the neuropsychiatric manifestation of liver disease w neurotoxic effects of pneumonia that can result in ■ asterixis - flapping tremors ■ Apraxia- inability to construct simple figures, perform tasks when asked ■ Fetor hepaticus- musty sweet odor of the patient's breath ● What treatments would be used for hepatic encephalopathy and why? ○ Lactulose to trap ammonia in the gut and cause a laxative effect resulting in removal of ammonia from the body ○ Antibiotics if pt is unresponsive to lactulose (don't think we need to know this tho) ● What behavioral changes might we see in a patient with hepatic encephalopathy? ○ Change in neurologic or mental status, inappropriate behavior, sleep