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Diagnostic ascitic tap in cirrhosis — SCE Acute Medicine MCQ

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EasyProcedural Knowledge in Acute MedicineDiagnostic ascitic tap in cirrhosisSCE Acute Medicine

A 55-year-old woman 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 suspected SBP with INR 2.1 and platelets 58. What is the most appropriate next step in management?

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Correct answer: C — Perform diagnostic ascitic aspiration without routine correction of INR

The key discriminator is that suspected SBP with INR 2.1 and platelets 58, which makes Perform diagnostic ascitic aspiration without routine correction of INR the single best answer. Call critical care for escalation is less appropriate because it does not address the dominant acute risk in the vignette; Start anticoagulation after assessing bleeding risk would fit a different presentation or later stage of care. Arrange urgent specialist referral and Arrange routine outpatient follow-up 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