A 54-Year-Old Man with a History of Hepatitis C Infection

question 268

Multiple Choice

A 54-year-old man with a history of hepatitis C infection is brought to the emergency department by his wife after several episodes of vomiting bright red blood.  He is admitted to the hospital and the appropriate treatment is initiated.  During morning rounds the next day, the patient is disoriented and cannot identify the month or his current location.  Physical examination shows significant abdominal distention and gynecomastia.  Repetitive flicking motions of the hands are seen when the patient is asked to outstretch his arms and dorsiflex his wrists.  Which of the following is most likely contributing to this patient's altered mental status?

• A)Accumulation of blood urea nitrogen
• B)Bacterial infection of the meninges
• C)Decreased gamma-aminobutyric acid receptor stimulation
• D)Increased absorption of nitrogenous substances by the gut
• E)Occlusion of the middle cerebral artery

---

Definitions:

Stockholders

Owners of shares in a company and thus, hold equity interest, enjoying benefits like dividends and voting rights.

Return On Preferred Stock

The dividend paid on preferred stock divided by the price of the preferred stock, representing the earnings returned on investments in preferred shares.

Stock Decreases

A decrease in the market price of a company's shares.

Cumulative Voting

Cumulative voting is a method used in corporate elections, allowing shareholders to allocate their votes in any manner they choose among the candidates, offering minority shareholders a better chance of representation.