A 52-year-old man on hemodialysis for chronic kidney disease presents with chest pain worse on lying down. Auscultation reveals a pericardial friction rub. Pericardiectomy specimen shows a shaggy fibrinous exudate coating both visceral and pericardial surfaces. What pattern of acute inflammation does this represent?

• A Serous inflammation
• B Suppurative inflammation
• C Pseudomembranous inflammation
• D Fibrinous inflammation ✓

Explanation

Greater increases in vascular permeability allow fibrinogen to escape into the extravascular space, where it polymerizes to fibrin. Grossly this creates the classic bread-and-butter appearance seen in uremic and rheumatic pericarditis. Serous inflammation yields protein-poor clear fluid, suppurative inflammation yields pus rich in neutrophils, and pseudomembranous inflammation describes an adherent necrotic membrane overlying mucosal surfaces such as in diphtheria, none of which matches the gross finding described.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.