Ascites

Question 1

What is Ascites

Answer 1

Fluid accumulation in abdo cavity due to cirrhosis

Question 2

What is the triad of causes of Ascites

Answer 2

Inflammation (Peritonitis, TB)
Low protein (Nephrotic, Hypoalbuminaemia)
Flow stasis (Cirrhosis, Budd Chiari)

Question 3

What are the presentations of Ascites

Answer 3

Abdo Distension
Shifting dullness and Fluid Thrill
Jaundice and Pruritis

Question 4

How is Ascites investigated

Answer 4

Shifting Dullness w/Flank Full and fluid thrill
Ascitic tap w/Peritocentesis
-WCC w/ MC+S
-Protein measurement (Transudate vs exudate)

Question 5

What will Transudate protein measurement show in ascites

Answer 5

Low protein + Low SAAG
Clear fluid
Increase hydrostatic pressure

Question 6

What will Exudate protein measurement show in ascites

Answer 6

High Protein + High SAAG
Cloudy fluid
Inflammation mediated/ Low oncotic pressure

Question 7

How is ascites treated

Answer 7

Treat cause
Spiranolactone (Increase Na excretion)
Paracentesis
Liver transplant

Question 8

What is SAAG

Answer 8

Serum Albumin Ascitic Gradient