Q: All of the following have shown possible beneficial effect in hepatic encephelopathy except?
A) Plasma aromatic amino acids (AAA)
B) Branched chain amino acids (BCAA)
C) Sodium benzoate
Objective of above question is to highlight the role of Amino Acids in hepatic encephelopathy. Evidence is still weak so this should not be used as standard of treatment, but should be kept in mind if situation requires intervention.
It has been suggested that hepatic failure/insufficiency increases the ratio of plasma aromatic amino acids (AAA) to branched-chain amino acids (BCAA), and can be a contributing cause of hepatic encephalopathy. Increasing the BCAA level may reverse this ratio and helps in preventing or improving hepatic encephelopathy.
BCAA is also available as an oral supplement, and may helpful as an adjuvant treatment.
So answer to above question is "A" as Aromatic Amino acid (AAA) can be detrimental. All other choices are of benefits in hepatic encephelopathy.
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