Three days after an extensive myocardial infarction, a 60-year-old man develops pleuritic chest pain worse on lying down. Auscultation reveals a pericardial friction rub. The pericardial exudate in this condition is best described as:
- A Fibrinous, with deposition of eosinophilic meshwork on the epicardium ✓
- B Serous, with low protein content and few cells
- C Suppurative, with abundant neutrophils and liquefactive necrosis
- D Hemorrhagic, with vascular injury and red cell extravasation
Correct answer: A. Fibrinous, with deposition of eosinophilic meshwork on the epicardium
Explanation
Post-infarction pericarditis produces a fibrinous exudate: increased vascular permeability allows fibrinogen to escape and polymerize into a shaggy eosinophilic meshwork over the epicardium, creating the friction rub. B purely serous exudate implies mild injury such as a blister. Suppurative exudates follow pyogenic infection, and hemorrhagic exudates accompany severe vascular injury or hemorrhagic diathesis, neither of which applies here.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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