🏥 USMLE Exam Prep

A 58-year-old man with a history of alcoholic cirrhosis presents with increasing abdominal distension and bilateral lower extremity edema. Paracentesis reveals ascitic fluid with a serum-ascites albumin gradient (SAAG) of 1.5 g/dL and a total protein of 0.8 g/dL. What is the most appropriate initial pharmacological treatment for his ascites?

A Furosemide alone
B Spironolactone alone
C Furosemide and spironolactone
D Large volume paracentesis

✓ Correct Answer: Option C

Ascites in cirrhosis with high SAAG indicates portal hypertension. The initial treatment involves diuretic therapy, primarily with a combination of spironolactone and furosemide in an appropriate ratio.

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