Gastrointestinal surgery: chylous ascites: practice question

A General Surgery 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 Surgery · Gastrointestinal surgery: chylous ascites

Sample item

A woman with abdominal lymphoma has progressive abdominal distension. Paracentesis yields opaque, milky fluid that does not clear on centrifugation. Which finding on fluid analysis confirms its nature?

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

The answer and the reasoning

C. Triglyceride level above that of plasma

Chylous ascites results from lymphatic obstruction or leak, for example from lymphoma, trauma or retroperitoneal surgery. The fluid is rich in chylomicrons, so its triglyceride content is markedly raised, usually above the plasma level.

Option by option

  • A. Neutrophil count above 250 per mm3

    A neutrophil count above 250 per mm3 indicates spontaneous bacterial peritonitis.

  • B. Serum-ascites albumin gradient above 1.1 g/dL

    A high gradient indicates portal hypertension, not lymphatic leak.

  • C. Triglyceride level above that of plasma (correct)

    Correct. A high triglyceride content, exceeding plasma, defines chylous ascites.

  • D. Acid-fast bacilli on smear

    Acid-fast bacilli would point to tuberculous peritonitis, which gives a lymphocytic straw-coloured fluid.

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 Surgery question

What is the answer to this General Surgery question?

The best answer is C, Triglyceride level above that of plasma. Chylous ascites results from lymphatic obstruction or leak, for example from lymphoma, trauma or retroperitoneal surgery.

Why is "Neutrophil count above 250 per mm3" not the answer?

A neutrophil count above 250 per mm3 indicates spontaneous bacterial peritonitis.

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

A high gradient indicates portal hypertension, not lymphatic leak.

Why is "Acid-fast bacilli on smear" not the answer?

Acid-fast bacilli would point to tuberculous peritonitis, which gives a lymphocytic straw-coloured fluid.

What concept does this question test?

It tests Gastrointestinal surgery: chylous ascites in General Surgery. The fluid is rich in chylomicrons, so its triglyceride content is markedly raised, usually above the plasma level.

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 Gastrointestinal surgery: chylous ascites?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.