A high blood level of which substance causes hepatic coma?

Bilirubin

Calcium

Ammonia

Sodium

Answer and Explanation

The Correct Answer is C

Choice A reason: While elevated bilirubin levels can indicate liver dysfunction and lead to jaundice, they are not the primary cause of hepatic coma. Bilirubin is a byproduct of red blood cell breakdown and its accumulation can cause yellowing of the skin and eyes.

Choice B reason: Calcium levels, whether high or low, can affect neuromuscular function and cardiac health, but they are not directly associated with causing hepatic coma. Hypercalcemia or hypocalcemia can present with various symptoms, but not typically with hepatic coma.

Choice C reason: Elevated ammonia levels are directly associated with hepatic coma. In patients with severe liver dysfunction, the liver cannot efficiently convert ammonia (a byproduct of protein metabolism) into urea for excretion. The accumulation of ammonia in the blood can cross the blood-brain barrier and lead to encephalopathy, resulting in confusion, altered mental status, and potentially hepatic coma.

Choice D reason: Sodium levels can affect neurological function, particularly with conditions like hypernatremia or hyponatremia. However, these imbalances are not the primary cause of hepatic coma. The direct link to hepatic coma is through elevated ammonia levels.

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Correct Answer is D

Explanation

Choice A reason: Idiopathic pulmonary fibrosis is a chronic, progressive lung disease characterized by scarring of the lung tissue. Tissue plasminogen activators (tPAs) are not used for this condition, as they are primarily designed to dissolve blood clots, not to address fibrotic changes in the lungs.

Choice B reason: Sarcoidosis is an inflammatory disease that affects multiple organs, particularly the lungs and lymph glands. It involves the growth of tiny collections of inflammatory cells called granulomas. Tissue plasminogen activators are not used in the treatment of sarcoidosis since the condition is not related to blood clots but rather to immune system dysregulation.

Choice C reason: Atelectasis is the complete or partial collapse of a lung or lobe of a lung due to alveoli deflation. The treatment typically focuses on re-expanding the lung tissue through techniques such as deep breathing exercises, bronchoscopy, or mechanical ventilation. Tissue plasminogen activators are not relevant for this condition, as they are used to dissolve blood clots, not to treat lung collapse.

Choice D reason: Pulmonary embolus (PE) is a blockage in one of the pulmonary arteries in the lungs, usually caused by blood clots that travel to the lungs from the legs or other parts of the body (deep vein thrombosis). Tissue plasminogen activators are used to treat PE because they can effectively dissolve the blood clots obstructing the pulmonary arteries, thereby restoring normal blood flow and preventing further complications.

A. Urine output of 30 mL/hr B. Blood pressure is 90/40 C. IV site is infiltrated D. Oral fluid intake of 100 mL for 8 hours

Correct Answer is B

Explanation

Choice A reason: Urine output of 30 mL/hr is concerning as it is on the lower end of normal and can indicate dehydration or impaired renal function. However, in this context, it is less immediately alarming compared to severely low blood pressure.

Choice B reason: Blood pressure of 90/40 is critically low and indicates hypotension, which can be a sign of severe dehydration or shock, especially in a patient with ongoing nausea and vomiting. This requires immediate attention and intervention to stabilize the patient and prevent further complications.

Choice C reason: An infiltrated IV site is a problem that needs to be addressed to ensure proper administration of fluids and medications. However, it is not as immediately life-threatening as hypotension.

Choice D reason: Oral fluid intake of 100 mL for 8 hours is inadequate, suggesting that the patient may be dehydrated. While concerning, it is not as acutely critical as low blood pressure, which directly affects perfusion and organ function.

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A high blood level of which substance causes hepatic coma?

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