The following are true regarding ascites except ?
**Core Concept**
Ascites refers to the accumulation of fluid in the peritoneal cavity, often due to cirrhosis, heart failure, or malignancy. The pathophysiology involves increased hydrostatic pressure, decreased oncotic pressure, or fluid shifts leading to ascitic fluid accumulation.
**Why the Correct Answer is Right**
Ascitic fluid accumulation can lead to significant morbidity, including respiratory compromise, abdominal discomfort, and increased risk of spontaneous bacterial peritonitis. The diagnosis of ascites is primarily clinical, with confirmation via ultrasound or paracentesis. In cases of cirrhosis, ascites is a marker of advanced liver disease and poor prognosis.
**Why Each Wrong Option is Incorrect**
**Option A:** Incorrect because ascites is not a contraindication for peritoneal dialysis; in fact, it is a common indication.
**Option B:** Incorrect because ascites is not typically associated with an increased white blood cell count; rather, an elevated white blood cell count in ascitic fluid is suggestive of spontaneous bacterial peritonitis.
**Option C:** Incorrect because ascites is not a normal finding in pregnancy; while some degree of fluid accumulation may occur, significant ascites is a pathologic finding.
**Clinical Pearl / High-Yield Fact**
A key point to remember is that the serum-ascites albumin gradient (SAAG) can help differentiate between transudative and exudative ascites. A SAAG ≥1.1 g/dL suggests a transudative etiology, such as cirrhosis or heart failure, while a SAAG <1.1 g/dL suggests an exudative etiology, such as malignancy or tuberculosis.
**Correct Answer: A. Ascites is a contraindication for peritoneal dialysis.**