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Spontaneous bacterial peritonitis — SCE Acute Medicine MCQ

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

HardAcute GI PresentationsSpontaneous bacterial peritonitisSCE Acute Medicine

A 74-kg man with cirrhosis has ascitic neutrophils 780/mm³ and is started on empirical antibiotics. His creatinine has risen from 86 to 142 micromol/L. Using estimated dry weight, which adjunctive albumin prescription best matches UK guidance?

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

Reveal the answer and explanation

Correct answer: E — Albumin 111 g within 6 hours, followed by 74 g on day 3

Explanation lettering: B = shown as A · A = shown as B · E = shown as D · D = shown as E

D is correct. Rising creatinine in SBP is the setting in which the BSG/BASL guideline recommends albumin 1.5 g/kg within 6 hours and 1 g/kg on day 3. For 74 kg, these are 111 g and 74 g. The 8 g/L rule applies after large-volume paracentesis, not simply because SBP is present. The other regimens either omit the day-3 dose or use unsupported dose proportions.

Reference: BSG/BASL guideline: ascites in cirrhosis: https://gut.bmj.com/content/70/1/9