Episode Chapters
- Hepatic Encephalopathy10:10Mental Health Effects of MarijuanaFree Chapter11:33Paper Chase 1: Sample Closet Medications are Neither Novel nor Useful5:31Point of Care CRP in Kids9:39Hyperhidrosis17:40Paper Chase 2: Semaglutide and Cardio Outcomes in Patients with Type 2 Diabetes4:51Things I Do But Should I: Post-Viral Cough7:22Contributor Profile: Vanessa Cardy, MD4:00Paper Chase 3: Long-Term Oxygen for COPD with Moderate Desaturation4:43Back to Basics: Aortic Stenosis9:07Bad Rashes in Newborns17:44Evaluation and Treatment of Diarrhea22:34Paper Chase 4: Cardio Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis5:18Not So Bad Rashes in Newborns22:52Paper Chase 5: Whole Brain Radiotherapy (WBRT)5:17The Summary15:59
Hepatic encephalopathy is a frequent neuropsychiatric complication of end stage liver disease caused by accumulation of ammonia and other neuro-toxins. It begins with subtle symptoms including sleep disruption and progresses to confusion, disorientation and potentially coma. Three year mortality rates after hospital admission exceed 70%. Treatment is directed at removing ammonia through bowels movements; lactulose is the mainstay of treatment, with rifampin playing a role in refractory cases.
Sweat Puddled, Brains Muddled Full episode audio for MD edition 173:58 min - 82 MB - M4AHippo Primary Care RAP February 2017 Summary 316 KB - PDF
Bob F. - February 5, 2017 8:27 AM
Do you mean rifaximin instead of rifampin?
Heidi J., MD - February 5, 2017 2:05 PM
You, sir, are correct!! Thanks for bringing that to our attention; fixing it right now.
Danielle K. - February 6, 2017 12:57 PM
brought me back to my hospital medicine days! Asterixis is really cool to see the first time-- it was one of those "omg that is what it looks like" moments for me!
Michelle M. - March 27, 2017 1:02 PM
Using miralax and lactulose together right now - yay for met enceph admits!
Heidi J., MD - March 29, 2017 5:17 PM
Fantastic! Is it working well?