A 52-year-old man with Child-Pugh B cirrhosis (score 8) secondary to alcohol presents with large volume ascites. Paracentesis of 6 litres is performed. Albumin infusion of 8 g per litre of ascites removed should be administered post-procedure. Total albumin required for this procedure is:

• A 24 g
• B 60 g
• C 8 g
• D 48 g ✓

Explanation

Post-paracentesis circulatory dysfunction (PPCD) prevention requires intravenous albumin 8 g per litre of ascites removed when the volume tapped exceeds 5 litres. For 6 litres removed: 6 × 8 g = 48 g of albumin. This prevents PPCD, which is associated with increased mortality, hyponatraemia, and hepatorenal syndrome. Albumin infusion is not required for taps ≤5 litres or if the tap was therapeutic (diagnosis only, small volume). The calculation is straightforward: 6 L × 8 g/L = 48 g.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.