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Ascitic drain in cirrhosis — SCE Acute Medicine MCQ

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ModerateProcedural Knowledge and Acute Management DecisionsAscitic drain in cirrhosisSCE Acute Medicine

A 59-year-old woman is assessed on the acute medical unit. She has tense ascites causing dyspnoea and undergoes planned drainage of 7 litres. Renal function is normal before the procedure. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate next step in management?

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Correct answer: D — Give human albumin solution during large-volume paracentesis

Give human albumin solution during large-volume paracentesis is the best answer because albumin replacement reduces circulatory dysfunction after large-volume paracentesis. Start intravenous N-acetylcysteine promptly 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: Diagnostic tap should also be considered for infection when admitted with decompensation.

Reference: BSG ascites guideline