Q2: Correct answer: D
Episodic hepatic encephalopathy is usually precipitant induced in over 80% of cases and precipitants include dehydration, infections, over diuresis, gastrointestinal bleeding, constipation, and the use of narcotics and sedatives. The key is to identify and treat the precipitant. A diagnostic workup to rule out other disorders that can alter brain function and mimic hepatic encephalopathy should also be performed.
Viltstrup H et al. Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology. 2014;60(2):715-35.