Atestace Vnitřní lékařství

Practice session

A 55-year-old woman with decompensated alcohol-related liver cirrhosis presents with progressive abdominal distension over 3 weeks. Physical examination demonstrates shifting dullness, fluid wave, and bilateral ankle edema, without fever or abdominal pain. Diagnostic paracentesis yields clear yellowish fluid: total protein 12 g/L, albumin 8 g/L, and polymorphonuclear leukocyte count 80/µL. Simultaneously drawn serum albumin is 24 g/L. What is the serum-ascites albumin gradient (SAAG), what does it indicate, and what is the foundational first-line medical therapy for this condition?

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