American Board of Internal Medicine (ABIM) Certification Practice Exam

What is a prior episode of SBP an indicator for?

1. A potential risk for recurrent infections

2. A definitive cure for SBP

3. A sign of effective treatment

4. A requirement for liver transplantation

The correct answer is: A potential risk for recurrent infections

A prior episode of spontaneous bacterial peritonitis (SBP) serves as a significant indicator of a potential risk for recurrent infections. This is primarily due to the underlying pathophysiology associated with SBP, which often occurs in patients with cirrhosis and portal hypertension. These conditions lead to an impaired immune response and altered ascitic fluid dynamics, predisposing individuals to bacterial infections. Research has shown that having a history of SBP significantly increases the likelihood of future episodes. Thus, the presence of a prior SBP episode necessitates closer monitoring and often prompts prophylactic measures to prevent recurrence, such as the administration of antibiotics. Recognizing this risk is crucial for managing patient care effectively and improving outcomes in individuals with liver disease. While a prior SBP episode does suggest that there have been treatment interventions, it does not indicate a definitive cure or effective treatment (as proposed in the other options). Additionally, it is not a direct requirement for liver transplantation, although recurrent infections do play a role in the overall prognosis and decisions regarding transplantation.