A 58-year-old man with chronic kidney disease presents with chest pain worse on lying down and relieved by sitting forward. Auscultation reveals a pericardial friction rub. At autopsy, the visceral and parietal pericardial surfaces are covered by shaggy strands of pink material that give them a dry, bread-and-butter appearance. This lesion represents which pattern of acute inflammation?

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

Explanation

Fibrinous inflammation develops when greater vascular injury allows large molecules such as fibrinogen to leak out; fibrin polymerizes on serosal surfaces, producing the shaggy exudate seen in uremic and rheumatic pericarditis. If fibrin is not removed by plasmin, it is organized by fibroblasts into permanent fibrous adhesions. In pure serous inflammation the fluid is protein-poor with few cells and no strands, so the gross bread-and-butter appearance excludes option A.

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.