Hepatobiliary Disease USMLE Step 1 Practice Question
A 60-year-old man with decompensated cirrhosis presents with fever (38.9°C), abdominal pain, and worsening confusion. Vital signs show BP 92/58, HR 108, RR 22, SpO2 98% on room air. Physical examination reveals tense ascites but no focal peritoneal signs. Diagnostic paracentesis yields turbid fluid with neutrophil count of 420 cells/mm³, total protein 1.2 g/dL, and negative bacterial culture. He denies recent antibiotic use. Which diagnosis best explains these findings?
Answer choices
- ASpontaneous bacterial peritonitisCorrect answer
- BBudd-Chiari syndrome
- CPerforated duodenal ulcer
- DPrimary sclerosing cholangitis
- EAcute pancreatitis
- FSecondary bacterial peritonitis
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