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Large-volume paracentesis — SCE Acute Medicine MCQ

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HardProcedural Knowledge in Acute MedicineLarge-volume paracentesisSCE Acute Medicine

A 67-year-old man presents with a procedure-related acute decision. Relevant history includes coagulation, imaging, respiratory physiology or procedural risk. On assessment, bedside findings determine whether the procedure is safe and urgent. Investigations show planned removal of 8 litres of ascites. What is the most appropriate next step in management?

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Correct answer: A — Give human albumin solution after large-volume paracentesis

The key discriminator is that planned removal of 8 litres of ascites, which makes Give human albumin solution after large-volume paracentesis the single best answer. Arrange urgent CT imaging is less appropriate because it does not address the dominant acute risk in the vignette; Arrange routine outpatient follow-up would fit a different presentation or later stage of care. Optimise chronic medication and discharge and Start anticoagulation after assessing bleeding risk are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: BSG/BASL ascites guideline