🏥 USMLE Exam Prep

A 62-year-old male with cirrhosis due to alcohol abuse presents with increasing abdominal distension and lower extremity edema. Paracentesis shows a serum-ascites albumin gradient (SAAG) > 1.1 g/dL and total protein < 2.5 g/dL. What is the most appropriate long-term pharmacological management to prevent recurrence of ascites?

A Repeated large-volume paracentesis
B Spironolactone and furosemide
C Transjugular intrahepatic portosystemic shunt (TIPS)
D Liver transplantation evaluation

✓ Correct Answer: Option B

Diuretics, specifically a combination of spironolactone and furosemide, are the cornerstone of medical management for cirrhotic ascites to reduce fluid retention and prevent recurrence.

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