virgola82
Forum Guru
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A 43 yo woman was well until 2 months ago when she noted gradually progressive abdominal distention and anorexia. She denies fever. Physical examination findings are notable for marked ascites without splenomegaly or spider angiomata. Lab tests show AST 25U/, alk phos 105 U/L total bilirubin 1mg/dl, albumin 3.5 g/dl and INR 1. Analysis of abdominal fluid shows a protein level of 5.9 g/dl and an albumin level of 3.1 g/dl. Which of the following would you advise?
A Ultrasonography of the liver with doppler of portal and hepatic veins
B Echocardiography
C Liver biopsy
D Repeat paracentesis with cytology
E Analysis of 24 hour urine speciemen for albumin
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| prasannakumar
Forum Senior
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D
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| Justice
Forum Fanatic
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D Repeat paracentesis with cytology
Could be of ovarian genesis...
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| sprint123
Forum Guru
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Great q! Let me analyse my part!
SAAG is < 1.1---> So, NOT Portal Hypertension--> A ruled out
Ascitic protein > 2.5 --> Exudative ascites ---> B and C ruled out
E would be good is pedal edema is present..
So, D is left-----Though, I am not sure why cytology ahs to be done?!
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| CocaCola
Forum Guru
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because it may be an ovarian malignancy
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