Gastroenterology Q 3

A 50-year-old man is evaluated for newly developed ascites. He has cirrhosis due to nonalcoholic steatohepatitis. Paracentesis confirms cirrhosis as a cause of the ascites and excludes infection, and a low-sodium diet is implemented. Medical history includes type 2 diabetes mellitus, hypertension, and dyslipidemia. Current medications are metformin, lisinopril, and atorvastatin. On physical examination, vital signs are normal. The abdomen is nontender and mildly distended, with normal bowel sounds. Serum creatinine level is 1.1 mg/dL (97.2 μmol/L). Random urine protein-creatinine ratio is 16 mg/g.

Which of the following is the most appropriate additional treatment?

A Discontinue atorvastatin

B Discontinue lisinopril

C Initiate lactulose

D Initiate low-protein diet

Choose an Answer Above

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