Gastrointestinal surgery: spontaneous bacterial peritonitis: practice question

A General Surgery 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 Surgery · Gastrointestinal surgery: spontaneous bacterial peritonitis

Sample item

A cirrhotic patient with ascites has fever and diffuse abdominal tenderness. Diagnostic paracentesis shows an ascitic neutrophil count of 400 per cubic mm. What is the treatment?

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

The answer and the reasoning

C. Intravenous third-generation cephalosporin with albumin

An ascitic neutrophil count of 250 or more per cubic mm diagnoses spontaneous bacterial peritonitis, treated with a third-generation cephalosporin and albumin to protect the kidneys. Laparotomy is not needed when there is no perforation. Long-term prophylaxis follows.

Option by option

  • A. Metronidazole alone

    Metronidazole alone does not cover the usual Gram-negative enteric organisms.

  • B. Large-volume paracentesis alone

    Paracentesis alone does not treat the infection.

  • C. Intravenous third-generation cephalosporin with albumin (correct)

    Correct. Cephalosporin plus albumin is standard treatment.

  • D. Emergency laparotomy

    The peritonitis is primary and not due to perforation, so surgery does not help.

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.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Intravenous third-generation cephalosporin with albumin. An ascitic neutrophil count of 250 or more per cubic mm diagnoses spontaneous bacterial peritonitis, treated with a third-generation cephalosporin and albumin to protect the kidneys.

Why is "Metronidazole alone" not the answer?

Metronidazole alone does not cover the usual Gram-negative enteric organisms.

Why is "Large-volume paracentesis alone" not the answer?

Paracentesis alone does not treat the infection.

Why is "Emergency laparotomy" not the answer?

The peritonitis is primary and not due to perforation, so surgery does not help.

What concept does this question test?

It tests Gastrointestinal surgery: spontaneous bacterial peritonitis in General Surgery. Laparotomy is not needed when there is no perforation. Long-term prophylaxis follows.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Gastrointestinal surgery: spontaneous bacterial peritonitis?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.