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7534 Medicine

A 60-year-old man with a known case of Hemochromatosis, cirrhosis and poal hypeension was brought to ED with altered mental status. Attendant describes that since the last 3 days ,the patient is confused , no h/o melena or hematemesis. For chronic ascites , diet control and spironolactone is given regularly . In the past he had an episode of variceal bleed for which he was put on propranolol and no episodes are seen since then. On examination he is not well oriented to time , place , but oriented to person .He is afebrile , vitals are stable , but ascites, asterixis, are notable. His laboratory investigation shows hemoglobin of 10.1 , Creatinine of 1.4 , and Blood urea nitrogen of 45. On paracentesis, clear fluid with 800 WBC (40% neutrophils) were seen. False statement regarding this condition:

AAscites is preceded by infection
BClinical features are abdominal pain, fever, leucocytosis and altered mental status
CAscitic fluid protein of 1 gm/dl
DCommon organisms are Gram negative organisms
Medicine
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