skip to main content

Spontaneous bacterial peritonitis — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateAcute GI PresentationsSpontaneous bacterial peritonitisSCE Acute Medicine

A 61-year-old man is assessed on the acute medical unit. He has cirrhosis, fever, abdominal pain and ascites. Ascitic neutrophils are 420 cells/mm3. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate next step in management?

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

Reveal the answer and explanation

Correct answer: B — Give broad-spectrum intravenous antibiotics within one hour

Give broad-spectrum intravenous antibiotics within one hour is the best answer because ascitic neutrophils above diagnostic threshold indicate SBP requiring immediate antibiotics. Start intravenous hydrocortisone after blood cultures is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Albumin reduces renal failure risk in selected SBP patients.

Reference: BSG cirrhosis guideline