An unconscious patient was delivered by ambulance to the hospital. On objective examination the patient was found to have no reflexes, periodical convulsions, irregular breathing. After laboratory examination the patient was diagnosed with hepatic coma. Disorders of the central nervous system develop due to the accumulation of the following metabolite:

Answer options

1. Bilirubin
2. Urea
3. Histamine
4. Glutamine
5. Ammonia

Explanation

An unconscious patient was taken by ambulance to the hospital. On objective examination the patient was found to have no reflexes, periodical convulsions, irregular breathing. After laboratory examination the patient was diagnosed with hepatic coma. Disorders of the central nervous system develop due to the accumulation of the following metabolite:The liver produces the enzymes involved in the urea cycle, which converts ammonia to urea. Elevated ammonia levels can result in hepatic encephalopathy.The neurologic symptoms accompanying severe liver disease have been termed hepatic coma. This syndrome is characterized by personality changes, inappropriate behavior, stupor, and eventually coma. The most frequent biochemical abnormality is an elevation of the blood ammonia. This results from the breakdown of nitrogenous products.