Elevated ammonia levels can lead to which condition?

• A. Hepatic encephalopathy
• B. Jaundice
• C. Splenomegaly
• D. Ascites

Answer: (A)

High ammonia levels reflect the liver’s reduced ability to detoxify ammonia into urea. Ammonia builds up in the bloodstream and crosses into the brain, where it is toxic to neurons and causes astrocyte swelling and disrupted neurotransmission. This combination leads to hepatic encephalopathy, presenting as changes in mental status, confusion, and may progress to lethargy or coma.

Other options are liver-related manifestations rather than direct consequences of ammonia elevation: jaundice results from excess bilirubin, ascites from portal hypertension and fluid shift, and splenomegaly from portal hypertension. They may occur with liver disease, but elevated ammonia specifically points to hepatic encephalopathy.