Ascites

Question 1

What?

Answer 1

Fluid accumulation in peritoneal space

Question 2

Pathophysiology

Answer 2

Increase pressure with portal HTN drive fluid into the peritoneal space and activates the RAAS pathway leading to fluid retention

Question 3

Signs/symptoms

Answer 3

Nausea

Abdominal pain and distention

Shortness of breath

Question 4

Non-pharm treatment

Answer 4

Sodium restriction < 2g/day

Liver transplant??

Question 5

First line treatment

Answer 5

Spironolactone + Furosemide

Initial: 100(S) ; 40 (F)
Max: 400 (S); 160 (F)

CANNOT USE IF AKI

Question 6

Second line treatment

Answer 6

Indication: Refractory ascites with diuretics, AKI

If > 5L removed–>ALBUMIN
Albumin 25% IV 6-8 g/L removed

AVOID NSAIDS