Gastroenterology Board Review Sample Questions

The correct answer is D. Large volume therapeutic and diagnostic paracentesis

Explanation: Large volume therapeutic and diagnostic paracentesis. Explanation: Large volume paracentesis is indicated for patients with initial onset of ascites with tense ascites and abdominal pain. Large volume paracentesis will provide relief rapidly and exclude spontaneous bacterial peritonitis. When performing large volume paracentesis, albumin 8g should be provided for each liter of fluid removed in order to prevent dilutional hyponatremia and renal impairment resulting from circulatory disturbance. (A) Large volume paracentesis should also be performed for relief of tense ascites and abdominal pain. Albumin should be administered when large volume paracentesis is performed. (B) Antibiotics are not indicated in this patient. They are appropriate for treatment of spontaneous bacterial peritonitis and for prophylaxis in patients with advanced cirrhosis with low levels of protein in ascitic fluid. (C) Midodrine is used in the treatment of hepatorenal syndrome. (E) After paracentesis, diuretics should be administered to prevent recurrence of ascites.