WBR0016

Author	PageAuthor::Raviteja Reddy Guddeti MBBS, Aarti Narayan MBBS
Exam Type	ExamType::USMLE Step 2 CK
Main Category	MainCategory::Internal medicine
Sub Category	SubCategory::Cardiovascular
Prompt	[[Prompt::A 45 year old male presented to the office with complaints of dyspnea and mild retrosternal chest pain radiating to the back and the shoulders. It is aggravated with lying down and coughing, and is relieved by sitting up and leaning forward. Physical examination is essentially normal. EKG shows widespread ST elevations and PR segment depressions. Echocardiogram showed mild effusion in the pericardial sac. Over the subsequent days, he developed progressive dyspnea. A therapeutic pericardiocentesis showed bloody fluid. What is the most likely diagnosis?]]
Answer A	AnswerA::Tuberculous pericarditis
Answer A Explanation	AnswerAExp::This is the correct answer.
Answer B	AnswerB::Coxsackie virus pericarditis
Answer B Explanation	AnswerBExp::Coxsackie virus pericarditis will give a clear transudative pericardial effusion.
Answer C	AnswerC::Collagen vascular disease induced pericarditis
Answer C Explanation	AnswerCExp::Collagen vascular disease induced pericarditis will give a clear transudative pericardial effusion.
Answer D	AnswerD::Myxedema
Answer D Explanation	AnswerDExp::Myxedema induced pericarditis will give a clear transudative pericardial effusion.
Answer E	AnswerE::Drug induced pericarditis
Answer E Explanation	AnswerEExp::Drug induced pericarditis will give a clear transudative pericardial effusion.
Right Answer	RightAnswer::A
Explanation	[[Explanation::The correct answer is tuberculous pericarditis. Among all of the options given, TB pericarditis is the only cause of bloody pericardial effusion. Malignant pericarditis is another cause of bloody pericardial effusion. Other rare causes are rheumatic fever, post-cardiac injury, post-myocardial infarction and uremic pericarditis. Educational Objective: References: ]]
Approved	Approved::Yes
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