skip to main content

Cirrhosis with low-protein ascites — ABIM Board MCQ

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

ModerateGastroenterology/HepatologyCirrhosis with low-protein ascitesABIM Board

A 56-year-old man with cirrhosis due to hepatitis C is admitted with tense ascites. Ascitic fluid has albumin 0.8 g/dL, total protein 0.9 g/dL, and neutrophils 42 cells/mm3. Serum sodium is 128 mEq/L and creatinine is 1.4 mg/dL. Which of the following would you recommend?

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

Reveal the answer and explanation

Correct answer: C — Primary prophylaxis against spontaneous bacterial peritonitis

Low ascitic protein plus renal dysfunction or hyponatremia increases SBP risk and supports primary antibiotic prophylaxis in selected patients. Current SBP is not present because ascitic neutrophils are below 250 cells/mm3.

Reference: AASLD Ascites and Spontaneous Bacterial Peritonitis Guidance