Manifestations associated with hepatic encephalopathy from chronic liver disease are the result of:
a. hyperbilirubinemia and jaundice.
b. fluid and electrolyte imbalances.
c. impaired ammonia metabolism.
d. decreased cerebral blood flow.
ANS: C
Hepatic encephalopathy effect on the liver prevents end products of intestinal protein digestion, particularly ammonia, from being converted to urea by the diseased liver. Impaired ammonia me-tabolism leads to the symptoms of hepatic encephalopathy. Symptoms are primarily neurologic, not jaundice oriented. Manifestations associated with hepatic encephalopathy are not associated with hyperbilirubinemia and jaundice, fluid, and electrolyte imbalances or decreased cerebral blood flow.
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