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Internal Medicine > Ascites > Flashcards

Flashcards in Ascites Deck (7)
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1

Definition

Collection of fluid in peritoneal cavity

2

Etiology

Hepatitis C
Alcoholic hepatitis
CHF
Nephrotic syndrome
Pancreatitis

Other causes of cirrhosis
Schistosomiasis
Constrictive pericarditis
Ovarian tumors
SLE
Protein losing enteropathy

3

History

Presence/risks of cirrhosis
Risks of hepatitis C
Family history
SOBOE, PND, orthop->CHF
Malignancy
Pancreatitis
Autoimmune disease

4

Physical examination

General
Stigmata of cirrhosis
JVP distension
Abdominal
Peripheral edema

5

Investigations

USS
FBC, LFT, UEC, albumin
Coagulation
Calculate MELD/Chigh Pugh
Serology for hepatitis B, A, C->determine status and need for immunisations
Abdominal paracentesis->cell count, differential, albumin, protein, culture, glucose, LDH, amylase, gram stain, TB smear/culture, cytology
Liver biopsy

6

What in the ascitic fluid suggests non-cirrhotic cause

ascitic fluid albumin gradient is high
Diagnosis based on SAAG:
>1.1g/dL: portal hypertension
Cirrhosis
Portal vein thrombosis
Budd chiari
CHF
Corrective pericarditis

7

Risks with paracentesis

Hematoma 1%