A patient with cirrhosis (severe liver impairment) is given a high‑protein diet. Analyze the potential risks and metabolic consequences related to amino acid handling and nitrogen balance in this patient.

• A. No risk exists because extrahepatic tissues fully compensate for all hepatic metabolic functions including the urea cycle, preventing any change in ammonia or nitrogen balance with high protein intake.
• B. Risk of impaired amino acid processing: reduced hepatic protein synthesis and impaired deamination/urea cycle may lead to elevated ammonia, altered amino acid plasma profiles, and reduced capacity to convert excess amino acids to glucose or fat, so high protein intake can worsen hepatic encephalopathy risk.
• C. High protein intake in cirrhosis directly reverses liver damage by stimulating hepatocyte regeneration without any metabolic side effects because amino acids become hepatotrophic growth factors only in diseased livers.
• D. Cirrhotic patients will convert excess amino acids directly to stored glycogen at higher rates than healthy people, improving energy reserves and lowering the risk of encephalopathy.

Answer: (B)