Core IM | Internal Medicine Podcast Hepatic Encephalopathy: 5 Pearls Edition Ep3
20 snips
Dec 13, 2017 AI Snips
Chapters
Transcript
Episode notes
Differential Diagnosis for Altered Mental Status in Cirrhotics
- Consider various diagnoses when a cirrhotic patient presents with altered mental status, not just hepatic encephalopathy (HE).
- Rule out life-threatening conditions like brain bleeds, Wernicke's encephalopathy, and infections.
Precipitants of Hepatic Encephalopathy
- When diagnosing HE, first ensure medication adherence.
- Then, consider infections, increased ammonia/azotemia, decreased ammonia clearance, or electrolyte imbalances.
Asterixis: More Than a Tremor
- Asterixis, often associated with HE, is a negative myoclonus (lapse in muscle contraction), not a tremor.
- It indicates dysfunction in brain areas controlling posture (thalamus, basal ganglia) and can be present in other encephalopathies.