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? 

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

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

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OpenLabyrinth
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Review your pathway

  • Starts smoking again
  • Νιώθει καλύτερα και σταματά να παίρνει τα φάρμακά της
  • Reschedule with alternative (e.g., WhatsApp call) if needed
  • new node
  • new node
  • 50nm to 1mm
  • PPIs are weak bases activated by protonation in parietal cells
  • Παραλείπει την επίσκεψη επανελέγχου στο γιατρό
  • Reschedule with alternative (e.g., WhatsApp call) if needed
  • arrest
  • Motor Exam
  • Η σημασία της ποιότητας του ύπνου
  • Η ασθενής λέει ότι μπορεί να είναι ουρική αρθρίτιδα και ζητά ένα συγκεκριμένο φάρμακο.
  • Empagliflozin (SGLT2 inhibitor)
  • Grab a juice from the open fridge
  • Ιβουπροφαίνη
  • Interphase, prophase, metaphase, anaphase, telophase
  • Επιφανειοδραστικός παράγοντας
  • Too long to wait
  • Basic Enzyme Definitions
  • How do scientists measure brain changes?
  • Noțiuni de bază despre enzime
  • Ipratropium (SAMA, anticholinergic))
  • Order a cappuccino and a kanelbulle
  • Basarse en rasgos físicos
  • I couldn’t see you clearly, can we adjust the visual presentation?
  • Organitele celulare
  • Educating your patient on self-management
  • Ο ασθενής χρησιμοποιεί μια εφαρμογή κινητής τεχνολογίας υγείας(mHealth)
  • PPIs are weak acids converted by CYP450 enzymes to the active form in parietal cells
  • All about he cares is playing and he doesn't get involved in the other courses.
  • Γενικές συμβουλές για την οστεοαρθρίτιδα γόνατος
  • new node
  • Alters ammonia metabolism by colonic bacteria

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