Complications of cirrhosis: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Complications of cirrhosis

Sample item

A cirrhotic patient with ascites has fever and abdominal tenderness. Diagnostic paracentesis is performed. Which ascitic fluid result confirms spontaneous bacterial peritonitis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Polymorphonuclear count of 250 cells/mm3 or more

Spontaneous bacterial peritonitis is infection of ascitic fluid without a surgical source, commonly with E. coli. It is diagnosed when the ascitic neutrophil count is 250/mm3 or higher. Treatment is a third-generation cephalosporin with albumin infusion.

Option by option

  • A. Serum-ascites albumin gradient below 1.1 g/dL

    A low gradient points to non-portal hypertensive causes such as malignancy or tuberculosis.

  • B. Red blood cell count over 50,000/mm3

    A very high red cell count suggests haemorrhagic ascites, as with malignancy or trauma.

  • C. Lymphocyte predominance with raised adenosine deaminase

    Lymphocytic ascites with high ADA suggests tuberculous peritonitis.

  • D. Polymorphonuclear count of 250 cells/mm3 or more (correct)

    Correct. This neutrophil threshold establishes the diagnosis even when cultures are negative.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Polymorphonuclear count of 250 cells/mm3 or more. Spontaneous bacterial peritonitis is infection of ascitic fluid without a surgical source, commonly with E.

Why is "Serum-ascites albumin gradient below 1.1 g/dL" not the answer?

A low gradient points to non-portal hypertensive causes such as malignancy or tuberculosis.

Why is "Red blood cell count over 50,000/mm3" not the answer?

A very high red cell count suggests haemorrhagic ascites, as with malignancy or trauma.

Why is "Lymphocyte predominance with raised adenosine deaminase" not the answer?

Lymphocytic ascites with high ADA suggests tuberculous peritonitis.

What concept does this question test?

It tests Complications of cirrhosis in General Medicine. coli. It is diagnosed when the ascitic neutrophil count is 250/mm3 or higher. Treatment is a third-generation cephalosporin with albumin infusion.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Complications of cirrhosis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.