Pericarditis

Question 1

Pericarditis

Answer 1

Inflammatory disorder of the pericardium which involves the visceral or/& parietal pericardial layers

Question 2

Etiology of pericarditis

Answer 2

Infectious
noninfectious
idiopathic

Question 3

Morphology classification of pericarditis

Answer 3

Acute

chronic

Question 4

Types of acute pericarditis

Answer 4

Serous pericarditis

fibrinous /serofibrinous pericarditis

purulent / fibrinopurulent pericarditis

hemorrhagic pericarditis

Caseous/ granulomatous pericarditis

Question 5

Commonest form of pericarditis

Answer 5

Fibrinous/ serofibrinous pericarditis

Question 6

When do you have serous pericarditis with serous exudate

Answer 6

In noninfectious inflammation:

Immunological mediated( rheumatic fever , SLE)

Tumors
uremia
Infection from tissue nearby causing sterile serious effusion

Viral infection
idiopathic

Question 7

Serous pericarditis morphology

Answer 7

Epicardium and pericardium inflammation
few polymorphs ,lymphocytes, macrophages

slow effusion

fibrous adhesions when resolved ( rare)

Question 8

Fibrinous and serofibrinous pericarditis characteristics

Answer 8

Abundant serous effusion with fibrinous exudate

Question 9

Fibtinous and serofibrinous pericarditis causes

Answer 9

Uremia

Acute MI

Autoimmune disease like acute rheumatic fever, SLE, rheumatoid arthritis, post myocardial infraction (Dressler syndrome ) ,chest radiation

post cardiac surgery

trauma

Question 10

Fibtinous and serofibrinous pericarditis Gross morphology

Answer 10

Shaggy granular fibrin deposits the epicardium and pericardium

Yellow and cloudy thick fluid with leukocytes and red cells and fibrin ( serofibrinous pericarditis )

Question 11

Fibtinous and serofibrinous pericarditis resolution

Answer 11

Digestion of the fibrin or organization (fibrous adhesions with partial or complete obliteration of pericardial cavity)

Question 12

Fibtinous and serofibrinous pericarditis produce what type of sound

Answer 12

Rubbing of pericardial surfaces against each other

Loud pericardial friction rub with pain

Question 13

In what case do you have purulent and fibrinopurulent pericarditis

Answer 13

Infection

Mostly bacterial or fungal

Question 14

Purulent pericarditis Morphology

Answer 14

Purulent exudate covers pericardium
Thick creamy pus

Red granular surface

Question 15

Is complete resolution usual in purulent pericarditis

Answer 15

No

Question 16

Major complication of purulent pericarditis

Answer 16

Constrictive pericarditis

Question 17

Most common association to hemorrhagic pericarditis

Answer 17

Malignant neoplastic tuberculous involvement of pericardium

Question 18

What often precedes hemorrhagic pericarditis

Answer 18

Cardiac surgery

Question 19

Healing of hemorrhagic pericarditis

Answer 19

By organization with fibrous adhesions

Question 20

Main cause of caseous/ granulomatous pericarditis

Answer 20

Tuberculosis

Question 21

Exudate in caseous pericarditis

Answer 21

Acute 
Turbid 
Bloodstained 
Tubercles on pericardial surface 
Subsides with fibrous adhesions

Fibrous tissue enclosing if become chronic
Calcification

Question 22

Type of chronic pericarditis

Answer 22

Chronic adhesive pericarditis

Chronic constrictive pericarditis

Question 23

Chronic adhesive pericarditis follows …

Answer 23

Pericarditis with fibrinous exudate which organize and form fibrin adhesions

Question 24

Chronic adhesive pericarditis more likely to develop after

Answer 24

Purulent pericarditis
Caseous pericarditis
Cardiac surgery
Irradiation

Question 25

What is adhesive mediastinal pericarditis

Answer 25

In chronic adhesive pericarditis there is risk of fibrous adhesions between the parietal pericardium and the Adjacent mediastinal structures

Question 26

Causes of chronic constrictive pericarditis

Answer 26

``` Tuberculosis Purulence Neoplasia Traumatic pericarditis Cardiac surgery Idiopathic Viral pericarditis ```

Question 27

Characteristics of constrictive pericarditis

Answer 27

Pronounced fibrous thickening of pericardium Rigidity of the heart interferes with heart action and circulation ( impaired diastolic relaxation and ventricular filling, decreased cardiac output) Pericardial cavity obliteration Calcification. And hyalinization of pericardium

Question 28

Morphology of heart in constrictive pericarditis

Answer 28

Normal or smaller than normal heart Sometime enlarged