MedBugs: SAQ #484

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Case: Spontaneous bacterial peritonitis

A 58-year-old woman presents with abdominal discomfort, fever and altered mental status. She has a history of liver cirrhosis with ascites. You suspect spontaneous bacterial peritonitis with hepatic encephalopathy.

1. List (4) features in the history and examination suggestive of hepatic encephalopathy. (4 marks) 4 marks

2. In addition to infection, list (4) common triggers of hepatic encephalopathy you would seek in your assessment. (4 marks) 4 marks

3. OTHER than liver cirrhosis, list (2) risk factors for SBP (2 marks) 2 marks

4. Complete the table below comparing primary and secondary bacterial peritonitis. (8 marks) 8 marks

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Case: Spontaneous bacterial peritonitis

1. List (4) features in the history and examination suggestive of hepatic encephalopathy. (4 marks) 4 marks

2. In addition to infection, list (4) common triggers of hepatic encephalopathy you would seek in your assessment. (4 marks) 4 marks

3. OTHER than liver cirrhosis, list (2) risk factors for SBP (2 marks) 2 marks

4. Complete the table below comparing primary and secondary bacterial peritonitis. (8 marks) 8 marks

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