UWorld Internal Medicine Practice Test 2025 – The All-In-One Resource to Master Your Exam Preparation!

Question: 1 / 400

In patients with liver cirrhosis, what is the most common cause of ascites?

Portal hypertension

The most common cause of ascites in patients with liver cirrhosis is portal hypertension. This condition arises due to increased pressure in the portal venous system, which can result from the scarring and fibrosis of liver tissue associated with cirrhosis. When the liver becomes damaged, blood flow through the liver is obstructed, leading to increased hydrostatic pressure in the portal vein. As a consequence, this increased pressure causes fluid to leak into the abdominal cavity, resulting in the accumulation of ascitic fluid.

Ascites itself is particularly associated with cirrhosis because the condition leads to both functional changes in the liver and alterations in the body's fluid balance. Renal responses to portal hypertension further exacerbate fluid retention and contribute to the development of ascites in these patients.

While the other factors mentioned can contribute to ascites, they are not the primary or most common causes in the context of cirrhosis. Peritoneal infections can occur as a complication but are usually a result of existing ascites. Malnutrition and heart failure can lead to fluid accumulation as well, but they are not as prevalent or direct in causing ascites specifically related to liver cirrhosis compared to portal hypertension.

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Peritoneal infections

Malnutrition

Heart failure

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