Organic psychiatry: hepatic encephalopathy: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Organic psychiatry: hepatic encephalopathy

Sample item

A cirrhotic patient is drowsy and disoriented with a flapping tremor of outstretched hands. Which drug is used to reduce the precipitating gut load of ammonia?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Lactulose

Hepatic encephalopathy features altered consciousness, asterixis and an altered sleep pattern, and is treated by correcting precipitants and giving lactulose and rifaximin. Sedatives and opioids can precipitate or worsen coma. Lactulose acidifies the colon and traps ammonia.

Option by option

  • A. Morphine

    Morphine worsens sedation in hepatic failure.

  • B. Diazepam

    Diazepam can precipitate coma in liver failure.

  • C. Chlorpromazine

    Chlorpromazine causes sedation and may worsen encephalopathy.

  • D. Lactulose (correct)

    Correct. Lactulose lowers ammonia absorption.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is D, Lactulose. Hepatic encephalopathy features altered consciousness, asterixis and an altered sleep pattern, and is treated by correcting precipitants and giving lactulose and rifaximin.

Why is "Morphine" not the answer?

Morphine worsens sedation in hepatic failure.

Why is "Diazepam" not the answer?

Diazepam can precipitate coma in liver failure.

Why is "Chlorpromazine" not the answer?

Chlorpromazine causes sedation and may worsen encephalopathy.

What concept does this question test?

It tests Organic psychiatry: hepatic encephalopathy in Psychiatry. Sedatives and opioids can precipitate or worsen coma. Lactulose acidifies the colon and traps ammonia.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Organic psychiatry: hepatic encephalopathy?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.