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  #1  
Old 09-26-2011
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Question Pericardaitis Question

A 49-year-old male patient has pericarditis. The pericardium is infiltrated by the fibrinous exudates, consisting of fibrin strands and leukocytes (mainly neutrophils). In this case, inflammatory cells do not penetrate the myocardium, and as a result, this particular variant does not present with diffuse ST elevation on ECG. On microscopic examination, this pathology is referred to as having a "Bread and Butter Appearance".

What is the most likely type of pericarditis in this patient?
A) Purulent Pericarditis
B) Hemorrhagic Pericarditis
C) Serous Pericarditis due to SLE
D) Uremic Pericarditis
E) Tuberculous Pericarditis
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Old 09-26-2011
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Damn, where did ya come up with those question, the 3 question u posted, made me think... This one just because is a "fibrinoid" Pericarditis, i guess is SLE.
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Old 09-26-2011
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Quote:
Originally Posted by rulz View Post
Damn, where did ya come up with those question, the 3 question u posted, made me think... This one just because is a "fibrinoid" Pericarditis, i guess is SLE.
I'm happy that you're thinking... BUT, Your answer is wrong... Note the whole story in the case presented !
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Old 09-26-2011
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uremic pericarditis
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Old 09-26-2011
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A) Purulent Pericarditis
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Old 09-26-2011
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A. purulent pericarditis
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Old 09-26-2011
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E) Tuberculous Pericarditis
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Old 09-27-2011
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bread and butter appearance is due to MI, but there is not even an option saying fibrinous pericarditis cuz that would have been my ans, so since I have to pick one, i will pick
Hemorrahgic pericarditis cuz of MI!
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Old 09-27-2011
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how do you say its MI, if not involving the myocardium as stated in the question.

my Reasons against MI:
No ST changes.
no involvement of myocardium.
pericarditis is a late phenomena in MI,but still you will have myocardial changes by then.

Too many neutrophils possily due to either inflammation(MI) or infective(bacterial).

wiki says its uremic pericarditis with bread and butter apperance.
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I think its uremic pericarditis
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Old 09-27-2011
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Quote:
Originally Posted by m82_ghasemi View Post
A 49-year-old male patient has pericarditis. The pericardium is infiltrated by the fibrinous exudates, consisting of fibrin strands and leukocytes (mainly neutrophils). In this case, inflammatory cells do not penetrate the myocardium, and as a result, this particular variant does not present with diffuse ST elevation on ECG. On microscopic examination, this pathology is referred to as having a "Bread and Butter Appearance".

What is the most likely type of pericarditis in this patient?
A) Purulent Pericarditis
B) Hemorrhagic Pericarditis
C) Serous Pericarditis due to SLE
D) Uremic Pericarditis
E) Tuberculous Pericarditis
Purulent Pericarditis
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A) Purulent Pericarditis.
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Old 09-27-2011
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Uremic pericarditis
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Old 09-27-2011
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Uremic pericarditis - fibrinous
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  #15  
Old 09-27-2011
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Correct Answer Answer

The correct answer is Uremic Pericarditis

Characteristics of Uremic Pericarditis:

1-
Fibrinous or serofibrinous pericarditis

2- Inflammatory cells (mainly neutrophils) do not penetrate the myocardium

3- Does not present with diffuse ST elevation

4- On microscopic examination, this pathology is referred to as having a "Bread and Butter Appearance"
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