IM_Quiz_8_answered - 1 A 55-year-old man with a 2-year history of alcoholic cirrhosis has a 3-day history of sharp diffuse abdominal pain and fever

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1. A 55-year-old man with a 2-year history of alcoholic cirrhosis has a 3-day history of sharp, diffuse abdominal pain and fever. Current medications are spironolactone, 200 mg/d; furosemide, 80mg/d; and nadolol, 20 mg/d. On physical examination, his temperature is 38.9°C , pulse rate is 62/min, and blood pressure is 110/62 mmHg. The abdomen is distended and tender to palpation, with shifting dullness. Leukocyte count 8800/ u L Blood urea nitrogen 60 mg/dL Serum creatinine 2.5 mg/dL Serum sodium 120 meq/L Serum potassium 3.0 meq/dL Serum asparate aminotransferase 90U/L Serum alanine aminotransferase 30 U/L Serum total bilirubin 3.7 mg/dL Abdominal sonography shows a large amount of ascites, cirrhosis without focal hepatic lesions, varices and an enlarged spleen. Paracentesis is done; the polymorphonuclear leukocyte count of the ascitic fluid is 650/ u L, and the albumin level is less than 1.0 g/dL. Which of the following is the most likely cause of the abdominal pain? A) Acute alcoholic hepatitis B) Cholecyctitis C) Massive ascites D) Splenic vein thrombosis E) Spontaneous bacterial peritonitis 2. A 70-year-old man comes to the office for a preoperative evaluation prior to transurethral resection of the
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This note was uploaded on 10/13/2010 for the course USMLE na taught by Professor Na during the Spring '10 term at St. Matthew's University.

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IM_Quiz_8_answered - 1 A 55-year-old man with a 2-year history of alcoholic cirrhosis has a 3-day history of sharp diffuse abdominal pain and fever

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