Which of the following is a potential cause of Portal Systemic Encephalopathy (PSE) in older adults?

Portal Systemic Encephalopathy (PSE), also referred to as hepatic encephalopathy, occurs when toxins that are normally cleared by the liver enter the bloodstream and affect brain function. In older adults, various conditions can contribute to the development of PSE.

GI bleeding is a potential cause because it can lead to increased absorption of nitrogenous substances, especially from the breakdown of blood in the gastrointestinal tract. These substances, which can include ammonia, may not be adequately processed by a compromised liver, leading to encephalopathy.

Dehydration can exacerbate PSE by causing renal impairment and altering metabolic processes. Inadequate hydration can lead to a decline in kidney function, which can contribute to the accumulation of toxins in the bloodstream and subsequently affect brain activity.

Electrolyte imbalances are also significant in this context. An imbalance, particularly of sodium and potassium, can influence neurological function and exacerbate symptoms of encephalopathy. Electrolyte disturbances can affect cell function and neuronal excitability, making individuals more susceptible to the cognitive impairments associated with PSE.

Considering that all these factors—GI bleeding, dehydration, and electrolyte imbalance—can contribute to the development or worsening of PSE in older adults reflects a comprehensive understanding of the