A patient is hospitalized with chronic pericarditis. On assessment, you note the patient has pitting edema in lower extremities, crackles in lungs, and dyspnea on exertion. The patient's echocardiogram shows thickening of the pericardium. This is known as what type of pericarditis?

Acute pericarditis

Constrictive pericarditis

Pericardial effusion

Effusion-Constrictive pericarditis

Answer and Explanation

The Correct Answer is B

A. Acute pericarditis: Acute pericarditis is characterized by inflammation of the pericardium, often presenting with pleuritic chest pain, pericardial friction rub, and diffuse ST-segment elevations on ECG. It does not typically involve pericardial thickening or chronic symptoms such as pitting edema and dyspnea on exertion.

B. Constrictive pericarditis: Chronic pericarditis with pericardial thickening suggests constrictive pericarditis, a condition where the pericardium becomes rigid and fibrotic, impairing diastolic filling and leading to heart failure symptoms such as peripheral edema, crackles in the lungs, and dyspnea on exertion. The echocardiogram findings confirm this diagnosis.

C. Pericardial effusion: Pericardial effusion refers to the accumulation of excess fluid in the pericardial sac, which can lead to cardiac tamponade if severe. However, the presence of pericardial thickening rather than fluid accumulation suggests constrictive pericarditis rather than an isolated effusion.

D. Effusion-constrictive pericarditis: This condition involves both pericardial effusion and constrictive pericarditis. While it may share some features with constrictive pericarditis, the case description primarily highlights pericardial thickening rather than significant effusion, making constrictive pericarditis the more accurate diagnosis.

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Correct Answer is C

Explanation

A. It does not remain dormant but some host defenses can kill the bacteria: While the immune system can kill some of the Mycobacterium tuberculosis bacilli, in many cases, the bacteria evade complete eradication and persist in a dormant state within the lungs. This does not mean the infection is fully eliminated, as it can reactivate later.

B. Virulence factors in the bacilli weaken over time, leading to apoptosis: Mycobacterium tuberculosis does not naturally lose its virulence over time. Instead, it can persist in a latent state due to immune containment, not because of a reduction in its ability to cause disease.

C. The bacilli can become isolated within tubercles in the lungs, possibly encapsulated: In latent tuberculosis, the immune system walls off the bacilli within granulomas (tubercles), preventing active disease. These granulomas may be encapsulated with fibrous tissue, restricting bacterial growth and spread. The bacteria remain dormant but can reactivate if the immune system weakens.

D. Macrophages attack and phagocytize new areas of infection: While macrophages do play a role in the immune response to tuberculosis, they are often unable to completely eradicate the bacilli. Instead, the bacteria can survive within macrophages and trigger the formation of granulomas, which help contain but not eliminate the infection.

A. Controlling the blood pressure B. Moderate alcohol use C. Eating a low fat diet D. Avoiding air pollution

Correct Answer is A

Explanation

A. Controlling the blood pressure: Controlling blood pressure is crucial for reducing the risk of developing coronary artery disease (CAD). Even with a normal lipid panel, hypertension can significantly contribute to cardiovascular risk, and managing blood pressure helps protect against the development of CAD.

B. Moderate alcohol use: While moderate alcohol consumption may have some potential benefits for heart health, it is not a primary risk factor reduction strategy. The focus should be on more impactful lifestyle changes, particularly for individuals with normal lipid levels.

C. Eating a low-fat diet: Although a balanced diet is important for overall health, a low-fat diet specifically is not necessary for everyone, especially those with normal lipid levels. The emphasis should be on a heart-healthy diet that includes healthy fats, such as those from fish, nuts, and olive oil, rather than simply reducing fat intake.

D. Avoiding air pollution: Avoiding air pollution can have health benefits, but it is not a primary strategy for individuals seeking to reduce the risk of CAD. Addressing more direct risk factors, such as blood pressure management, is more critical in this context.

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A patient is hospitalized with chronic pericarditis. On assessment, you note the patient has pitting edema in lower extremities, crackles in lungs, and dyspnea on exertion. The patient's echocardiogram shows thickening of the pericardium. This is known as what type of pericarditis?

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Naxlex Comprehensive Predictor Exams

A fellow student asks you to explain how tuberculosis (TB) can remain dormant in some people. What explanation will you give?

Correct Answer is C

Explanation

A person wishes to reduce the risk of developing coronary artery disease. This person has normal lipid panel. What risk factor reduction would the healthcare professional advise for this person?

Correct Answer is A

Explanation

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