CBC
Chemistry
Ammonia level
LFTs
PT/PTT
Urinalysis
CXR
Head CT
Paracentesis in patient with ascites (rule out SBP)
Consider LP
Full neuro exam including asterixis
Elevated ammonia level. Ammonia is not predictive of severity of disease.
History of any new medications or toxin ingestion
Focus exam on looking for signs of GI bleed or hypovolemia
Hepatic encephalopathy
Subdural Hematoma
Ethanol toxicity
Hypoglycemia
Methanol toxicity
Wernicke-Korsakoff Syndrome
Acute hepatitis
Hyper/hyponatremia