Azerbaijan Medical Residents Final Attestation Practice Questions - Azerbaijan Medical Residents Final Attestation Examination (Həkim-Rezidentlərin Yekun Attestasiyası) Exam

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A 48-year-old male with chronic hepatitis B cirrhosis presents with sudden confusion, inverted sleep-wake cycle, and flapping tremor of outstretched hands (asterixis). Blood ammonia is elevated. After excluding gastrointestinal bleeding, constipation, and sedative use, what is the first-line medical therapy for hepatic encephalopathy?

Oral Lactulose (titrated to 2–3 soft bowel movements daily) combined with oral Rifaximin High-dose intravenous loop diuretics Oral branched-chain amino acid restriction with absolute protein deprivation Intravenous Diazepam infusion for neurological stabilization

Correct Answer:

Oral Lactulose (titrated to 2–3 soft bowel movements daily) combined with oral Rifaximin

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