A 57-Year-Old Man with a History of Alcohol-Induced Cirrhosis Is Brought

question 454

Multiple Choice

A 57-year-old man with a history of alcohol-induced cirrhosis is brought to the emergency department due to altered mental status.  Over the weekend, he ate a lot of smoked meats at a local barbecue competition.  Since then, he has been sleeping most of the day and is confused and disoriented when awake.  On examination, he has abdominal distension with shifting dullness.  The patient answers correctly when asked for his name but does not know that he is in the hospital and says the year is "1997."  When asked to extend his hands as if stopping traffic, the patient makes rhythmic flapping movements.  He is started on rifaximin.  Which of the following is the most likely mechanism of action of this drug when used to treat this patient's current condition?

• A)Binding of dietary phosphate
• B)Decreased intraluminal ammonia production
• C)Exchange of intraluminal sodium ions for potassium ions
• D)Formation of a nonabsorbable complex with bile acids
• E)Increased conversion of ammonia to ammonium ion

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Definitions:

Attribution Theory

A psychological theory focused on how individuals interpret events and how this relates to their thinking and behavior.

High Consensus

A situation where there is widespread agreement among members of a group or organization, often indicating uniformity of opinion or perspective.

External Attribution

The process of attributing the cause of an observed behavior or outcome to factors outside the individual, such as the situation or other people.

Self-Fulfilling Prophecies

Expectations about a situation or individual that elicit behaviors which make the prediction come true, reinforcing the original expectation.