Hepatology: spontaneous bacterial peritonitis: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Hepatology: spontaneous bacterial peritonitis

Sample item

A patient with cirrhosis and ascites develops fever, abdominal discomfort, and worsening encephalopathy. Which test is required urgently to evaluate for spontaneous bacterial peritonitis?

AColonoscopy after bowel preparationBBarium swallowCRoutine liver ultrasound onlyDDiagnostic paracentesis with ascitic fluid cell count and culture

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Diagnostic paracentesis with ascitic fluid cell count and culture

Spontaneous bacterial peritonitis is diagnosed by sampling ascitic fluid, particularly the polymorphonuclear cell count and culture. It can be subtle and should be considered in deteriorating patients with ascites.

Option by option

A. Colonoscopy after bowel preparation
Bowel preparation may be unsafe in an acutely unwell cirrhotic patient and does not diagnose SBP.
B. Barium swallow
A barium swallow evaluates esophageal structure, not ascitic infection.
C. Routine liver ultrasound only
Ultrasound can demonstrate fluid but cannot exclude infection.
D. Diagnostic paracentesis with ascitic fluid cell count and culture (correct)
Correct. Ascitic fluid analysis is essential for diagnosis and directs urgent treatment.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Diagnostic paracentesis with ascitic fluid cell count and culture. Spontaneous bacterial peritonitis is diagnosed by sampling ascitic fluid, particularly the polymorphonuclear cell count and culture.

Why is "Colonoscopy after bowel preparation" not the answer?

Bowel preparation may be unsafe in an acutely unwell cirrhotic patient and does not diagnose SBP.

Why is "Barium swallow" not the answer?

A barium swallow evaluates esophageal structure, not ascitic infection.

Why is "Routine liver ultrasound only" not the answer?

Ultrasound can demonstrate fluid but cannot exclude infection.

What concept does this question test?

It tests Hepatology: spontaneous bacterial peritonitis in General Medicine. It can be subtle and should be considered in deteriorating patients with ascites.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hepatology: spontaneous bacterial peritonitis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.