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Encapsulating Peritoneal Sclerosis — RACP Adult Medicine MCQ

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HardNephrologyEncapsulating Peritoneal SclerosisRACP Adult Medicine

A patient on peritoneal dialysis has cloudy effluent and abdominal pain. Effluent contains 420 leukocytes/µL with 85% neutrophils. He is haemodynamically stable and there is no exit-site infection. What is the best initial antibiotic route?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Collect effluent cultures and start broad empiric intraperitoneal antibiotics

Explanation lettering: D = shown as B · E = shown as D · B = shown as E

B is correct. This meets peritoneal-dialysis peritonitis criteria; cultures are collected promptly and empiric intraperitoneal broad coverage is preferred when systemic sepsis is absent. C under-treats. D disregards direct high-concentration delivery. E is not routine for a first uncomplicated episode. A risks technique failure and sepsis.

Reference: Australian Prescriber, Prescribing and peritoneal dialysis: https://australianprescriber.tg.org.au/articles/prescribing-and-peritoneal-dialysis.html