Gastroenterology and hepatology: spontaneous bacterial peritonitis: 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 · Gastroenterology and hepatology: spontaneous bacterial peritonitis

Sample item

A man with cirrhosis and ascites develops fever and diffuse abdominal tenderness. Ascitic fluid analysis shows 600 neutrophils per microlitre. What is the most appropriate treatment?

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

The answer and the reasoning

A. Intravenous cefotaxime with albumin

An ascitic fluid neutrophil count of 250 per microlitre or more establishes spontaneous bacterial peritonitis. Treatment is with a third-generation cephalosporin such as cefotaxime, and intravenous albumin reduces hepatorenal syndrome and mortality.

Option by option

  • A. Intravenous cefotaxime with albumin (correct)

    Correct. A third-generation cephalosporin with albumin is standard treatment.

  • B. Oral rifaximin alone

    Rifaximin is not a treatment for established peritoneal infection.

  • C. Intravenous metronidazole with furosemide

    Metronidazole lacks cover for the usual enteric gram-negative organisms and furosemide may worsen renal function.

  • D. Therapeutic paracentesis alone

    Paracentesis removes fluid but does not treat the infection.

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 General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Intravenous cefotaxime with albumin. An ascitic fluid neutrophil count of 250 per microlitre or more establishes spontaneous bacterial peritonitis.

Why is "Oral rifaximin alone" not the answer?

Rifaximin is not a treatment for established peritoneal infection.

Why is "Intravenous metronidazole with furosemide" not the answer?

Metronidazole lacks cover for the usual enteric gram-negative organisms and furosemide may worsen renal function.

Why is "Therapeutic paracentesis alone" not the answer?

Paracentesis removes fluid but does not treat the infection.

What concept does this question test?

It tests Gastroenterology and hepatology: spontaneous bacterial peritonitis in General Medicine. Treatment is with a third-generation cephalosporin such as cefotaxime, and intravenous albumin reduces hepatorenal syndrome and mortality.

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 Gastroenterology and hepatology: spontaneous bacterial peritonitis?

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.