Hepatology: hepatic encephalopathy: practice question

A General Medicine 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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General Medicine · Hepatology: hepatic encephalopathy

Sample item

Lactulose improves hepatic encephalopathy primarily by what action?

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

The answer and the reasoning

A. Trapping ammonia in the colon as ammonium

Lactulose acidifies colonic contents and increases bowel transit, reducing absorption of ammonia. Precipitants such as bleeding, infection and constipation should be sought.

Option by option

  • A. Trapping ammonia in the colon as ammonium (correct)

    Correct. Ammonia is retained in the gut and excreted.

  • B. Blocking GABA receptors

    GABA blockade is not its mechanism.

  • C. Raising portal pressure

    It does not raise portal pressure.

  • D. Increasing hepatic ammonia production

    It lowers rather than increases ammonia burden.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Trapping ammonia in the colon as ammonium. Lactulose acidifies colonic contents and increases bowel transit, reducing absorption of ammonia.

Why is "Blocking GABA receptors" not the answer?

GABA blockade is not its mechanism.

Why is "Raising portal pressure" not the answer?

It does not raise portal pressure.

Why is "Increasing hepatic ammonia production" not the answer?

It lowers rather than increases ammonia burden.

What concept does this question test?

It tests Hepatology: hepatic encephalopathy in General Medicine. Precipitants such as bleeding, infection and constipation should be sought.

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 Hepatology: hepatic encephalopathy?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.