A 50-year-old man with chronic kidney disease presents with chest pain that worsens on lying down. Auscultation reveals a pericardial friction rub. At autopsy, both layers of the pericardium show shaggy deposits of pink-gray material resembling butter spread on bread. Which pattern of acute inflammatory exudate does this represent?
- A Serous inflammation
- B Fibrinous inflammation ✓
- C Suppurative inflammation
- D Catarrhal inflammation
Correct answer: B. Fibrinous inflammation
Explanation
The bread and butter appearance is classic for fibrinous pericarditis, seen in uremia, acute rheumatic fever, and myocardial infarction. Greater vascular permeability allows fibrinogen to escape and polymerize as fibrin on the serosal surface. In serous inflammation the exudate is protein-poor fluid without abundant fibrin, and suppurative inflammation would produce pus with numerous neutrophils rather than a shaggy fibrin deposit.
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.