AMS – HEPATIC [[Encephalopathy (Altered (Level Of) Consciousness)]]

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AMS – HEPATIC [[Encephalopathy (Altered (Level Of) Consciousness)]]
This is a @AGE@ @SEX@ with a presentation consistent with acute [[Hepatic [[Encephalopathy (Altered (Level Of) Consciousness)]]]]. Exam notable for stigmata of [[Cirrhosis]] and [[PH (Portal [[HTN; HBP (Hypertension; High Blood Pressure; ≥ 140\90 mmHg)]])]]. Likely precipitant: increased ammonia levels (GIB // excess protein // infection // electrolyte and/or acid base disturbance// [[Constipation]]) // dehydration (vomiting, diuretic use) // medication induced (opioids, [[Benzodiazepine Overdose]] or withdrawal // ETOH use.*** Low suspicion for acute GIB, including evidence of life threatening [[Hemorrhage]]. Low suspicion for acute infection including SBP (no fevers, [[Abdominal Pain]]). Presentation not consistent with other acute, emergent causes of [[AMS (Altered Mental Status)]] (including but not limited to renal failure, ICH) at this time.
Plan: labs, LFTs, ammonia level, PT/INR, UA, CXR, CT brain*, diagnostic paracentesis*, serial reassessment
AMS – HEPATIC [[Encephalopathy (Altered (Level Of) Consciousness)]]
This is a @AGE@ @SEX@ with a presentation consistent with acute [[Hepatic [[Encephalopathy (Altered (Level Of) Consciousness)]]]]. Exam notable for stigmata of [[Cirrhosis]] and [[PH (Portal [[HTN; HBP (Hypertension; High Blood Pressure; ≥ 140\90 mmHg)]])]]. Likely precipitant: increased ammonia levels (GIB // excess protein // infection // electrolyte and/or acid base disturbance// [[Constipation]]) // dehydration (vomiting, diuretic use) // medication induced (opioids, [[Benzodiazepine Overdose]] or withdrawal // ETOH use.*** Low suspicion for acute GIB, including evidence of life threatening [[Hemorrhage]]. Low suspicion for acute infection including SBP (no fevers, [[Abdominal Pain]]). Presentation not consistent with other acute, emergent causes of [[AMS (Altered Mental Status)]] (including but not limited to renal failure, ICH) at this time.
Plan: labs, LFTs, ammonia level, PT/INR, UA, CXR, CT brain*, diagnostic paracentesis*, serial reassessment

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