Alters ammonia metabolism by colonic bacteria

Excellent! Lactulose is metabolized into lactic acid in the colon. This leads to acidification of ammonia, a biomolecule which has been implicated in hepatic encephalopathy. Ammonium becomes entrapped in the GI tract and is removed in feces. Acidification of the colon also results in reduced production of ammonia by colonic bacteria. 

Investigations

You review Andrew's blood results. 

Bilirubin: 41 mmol/L (<17) 

Albumin: 32 g/L (35-45) 

Alkaline phosphatase: 145 IU/L (30-100) 

Alanine transaminase: 8300 IU/L (<40) 

Gamma-glutamyl transferase: 1031 IU/L (<70) 

Creatinine: 405 micromol/L (60-100) 

Paracetamol: Not detected 

INR: 7.2 (0.8-1.1) 

You proceed to place Andrew on the liver transplant list. A few hours later, a liver becomes available and Andrew is taken to the operating theater. 

What is the most accurate statement based on the investigations? 

  • Paracetamol has been metabolized
  • There is a risk for a thromboembolic event
  • Cholestasis is the most likely diagnosis
  • The patient presentation is not due to paracetamol overdose

Map: Andrew Hall (1102)
Node: 20963
Score:

reset

OpenLabyrinth
OpenLabyrinth is an open source educational pathway system

Review your pathway

  • 37⁰C, 1% O2 levels, 5% CO2 levels.
  • Blame the patient for non-adherence
  • new node
  • Allow only one profession to speak the entire time
  • Ignorar la probabilidad porque ya sabemos que la FQ es recesiva
  • Tell the patient to change devices without giving proper guidance.
  • PPIs are weak bases activated by protonation in parietal cells
  • Motor Exam
  • Empagliflozin (SGLT2 inhibitor)
  • Option 1
  • Οι περιοχές Β και D είναι επιμολυσμένες και παρουσιάζουν υψηλό βακτηριακό φορτίο.
  • How do scientists measure brain changes?
  • Echipament de protecție în laborator
  • Interfază, profază, prometafază, metafază, anafază, telofază
  • Αύξηση της συγκέντρωσης του υποστρώματος
  • Protocolul experimental pentru testul Fehling
  • Ipratropium (SAMA, anticholinergic))
  • Order a cappuccino and a kanelbulle
  • Resultados de los cultivos líquidos
  • Organitele celulare
  • I couldn’t see you clearly, can we adjust the visual presentation?
  • PPIs are weak acids converted by CYP450 enzymes to the active form in parietal cells
  • Descrierea 2
  • Ca să nu ne facă observație instructorul de laborator
  • Assign a coordinator but without explaining roles
  • Alters ammonia metabolism by colonic bacteria

Reminder

empty_reminder_msg

FINISH

Time is up