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Miriam Strichen: Discussion

What diagnostic test would you pursue first to diagnose an etiology for the patient's ascites?

The patient undergoes a paracentesis. Two liters of clear ascitic fluid is removed with the following values:

  • Protein 1.8 mg/dL
  • Glucose 105
  • Amylase 20
  • WBC 152 (13 segs, 20 monos, 67 tissue cells)
  • Gram stain reveals no bacteria.

How would you characterize the patient's ascites?

What would you do now to evaluate the etiology?

How would you approach management of this condition on a long-term basis?


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