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Spontaneous bacterial peritonitis — USMLE Step 2 CK MCQ

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ModerateInternal MedicineSpontaneous bacterial peritonitisUSMLE Step 2 CK

A 42-year-old White man comes to the urgent care clinic because of abdominal pain or gastrointestinal symptoms. History and focused examination are notable for cirrhosis with fever, abdominal pain, ascites, and neutrophil-predominant fluid. Temperature is 102.2°F (39.0°C), blood pressure is 108/66 mmHg, pulse is 112/min, respirations are 22/min, and oxygen saturation is 94% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and initial testing support the clinical pattern described in the stem. Which of the following is the most appropriate pharmacotherapy?

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

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Correct answer: B — Cefotaxime plus intravenous albumin

The vignette describes Spontaneous bacterial peritonitis, supported by cirrhosis with fever, abdominal pain, ascites, and neutrophil-predominant fluid. Cefotaxime plus intravenous albumin is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: AASLD 2021 Ascites and SBP Guidance