A 50-year-old with cirrhosis develops confusion, asterixis, and elevated ammonia. His medications include furosemide and spironolactone. What is the most appropriate immediate treatment for hepatic encephalopathy?
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A
Lactulose titrated to 2-3 soft stools per day
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B
Neomycin IV
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C
Protein restriction to 0 g/day
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D
Fresh frozen plasma