Escolar Documentos
Profissional Documentos
Cultura Documentos
LABS:
Rev 2-2011
QUESTIONS:
1.
What aspects of this patient's history and physical suggest the presence of
ascites?
2.
What other information would you seek from this patient, and what are the
possible etiologies for her ascites?
3.
4.
The patient undergoes a paracentesis. Two liters of clear ascitic fluid is removed
with the following values: albumin 0.7 gm/dL, protein 1.8 mg/dL, glucose 105,
amylase 20, WBC 152 (13 segs, 20 monos, 67 tissue cells); gm stain reveals no
bacteria. Serum albumin is 2.5 gm/dL.
5.
How does this information assist you in the determining the cause of the
patients ascites?
The patient undergoes abdominal ultrasound which reveals a small, irregular
liver and enlarged spleen in addition to ascites. No abnormal pelvic mass lesions
are noted.
6. What pharmacologic therapy would you initiate at this time? How would you
monitor the effectiveness of your therapy in the hospital?
Rev 2-2011
7.
What additional lifestyle changes would assist in the successful treatment of the
ascites in the long term?
Rev 2-2011