starcraftbw
Forum Senior
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51 y/o female pt complains of increasing abdominal size and mild disconfort. PMH: HTN, CAD, DM. pt smokes, drinks and IV drug use. Physical exam show mild abdomen distension, mild tender, soft and increase bowel sounds. Paracentesis shows high WBCs, ascites albumin is 2.8, LDH is normal. LFT shows total bili = 1.1, direct bili = .6., alb = 3.6. what's the most likely diagnosis?
a) Ovarian cancer
b) Liver cirrhosis
c) Portal hypertension
d) Ischemic bowel
e) CHF secondary to HTN
f) Core pulmonale due to smoking and HTN
g) Splenomegaly
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| Kamsi
Forum Guru
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B
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| Justice
PGY-I, now officially
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a) Ovarian cancer
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The winner takes it all...
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| Dr.D
Forum Senior
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B, The Serum-ascities albumin gradient (SAAG) is probably a better discriminant than older measures (transudate versus exudate) for the causes of ascites. A high gradient (> 1.1 g/dL) indicates the ascites is due to portal hypertension. A low gradient (< 1.1 g/dL) indicates ascites of non-portal hypertensive etiology.
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| Dr.D
Forum Senior
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Sorry I mean Answer A
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| Kamsi
Forum Guru
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Justice ,I agree with U.Found out that it's an exudate .The serum-ascites album gradient (SAAG)is < 1.5 n ascites prot > 25g/dl for it to be an exudate mostly a malignancy.If SAAG is > 1.5 ,ascites prot.< 25g/dl it'll be a transudate most likely liver cirrhosis
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| peraspera
Forum Elite
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A.
input to Dr.D
http://www.medstudents.com.br/medint/medint3.htm
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| starcraftbw
Forum Senior
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the answer is A.......... exudate........
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