Haemodynamics: serum-ascites albumin gradient: practice question

A Pathology 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.

Try it

Pathology · Haemodynamics: serum-ascites albumin gradient

Sample item

A 50-year-old man with long-standing alcohol use has abdominal distension. Paracentesis shows a clear fluid with serum-ascites albumin gradient 1.6 g/dL and ascitic protein 1.0 g/dL. What is the main mechanism of ascites formation?

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

The answer and the reasoning

C. Raised hydrostatic pressure in the portal and sinusoidal bed

A gradient of 1.1 g/dL or more indicates portal hypertension, with high hydrostatic pressure and low oncotic pressure producing a low-protein transudate. Peritoneal disease such as tuberculosis or carcinomatosis gives a gradient below 1.1 and protein-rich fluid.

Option by option

  • A. Leakage of pancreatic secretions into the peritoneum

    Pancreatic ascites has high amylase and a low gradient.

  • B. Increased vascular permeability from peritoneal inflammation

    Inflammatory permeability gives a high-protein exudate with a low gradient.

  • C. Raised hydrostatic pressure in the portal and sinusoidal bed (correct)

    Correct. A high gradient with low protein is typical of portal hypertension in cirrhosis.

  • D. Obstruction of lymphatics by malignant deposits

    Lymphatic obstruction by tumour is a feature of malignant, low-gradient ascites.

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.

More Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, Raised hydrostatic pressure in the portal and sinusoidal bed. A gradient of 1.

Why is "Leakage of pancreatic secretions into the peritoneum" not the answer?

Pancreatic ascites has high amylase and a low gradient.

Why is "Increased vascular permeability from peritoneal inflammation" not the answer?

Inflammatory permeability gives a high-protein exudate with a low gradient.

Why is "Obstruction of lymphatics by malignant deposits" not the answer?

Lymphatic obstruction by tumour is a feature of malignant, low-gradient ascites.

What concept does this question test?

It tests Haemodynamics: serum-ascites albumin gradient in Pathology. 1 g/dL or more indicates portal hypertension, with high hydrostatic pressure and low oncotic pressure producing a low-protein transudate. Peritoneal disease such as tuberculosis or carcinomatosis gives a gradient below 1.1 and protein-rich fluid.

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 Haemodynamics: serum-ascites albumin gradient?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.