3 Months Of Progressive in Medicine / Internal Medicine — 44yo Man | Hepatology | SMLE Q#17902
SMLE Question #17902
Medicine / Internal Medicine
Hepatology
Objective: OBJ-HEP-ASCITES-001
Last updated: February 2026
A 44-year-old man with chronic hepatitis B–related cirrhosis presents with 3 months of progressive abdominal distension, bilateral leg edema, and 10-kg weight gain. He reports early satiety but no fever, abdominal pain, confusion, hematemesis, or melena. Examination shows jaundice, shifting dullness, moderate ascites, and 2+ pitting edema to the shins. Diagnostic paracentesis has been performed. In addition to a salt-restricted diet, what is the most appropriate next step in management?
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