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Pathophysiology of hepatic encephalopathy
Liver failure (loss of over 80-90% of function) → ↓ Ammonia clearance → ↑ Systemic ammonia levels Ammonia enters the brain → Astrocytes uptake ammonia + glutamate → glutamine (via glutamine synthetase) Glutamate ↓ (excitatory neurotransmitter) → Depressed neural activity → lethargy/coma Glutamine ↑ → Astrocyte swelling ...
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