Inflammation: fibrinous exudate: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Pathology · Inflammation: fibrinous exudate

Sample item

A 52-year-old man with end-stage renal disease has chest pain and a pericardial friction rub. At autopsy the pericardial surfaces are covered with a shaggy, 'bread and butter' fibrinous exudate. If the fibrin is not removed by fibrinolysis, what is the most likely outcome?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Organisation into fibrous adhesions between the pericardial layers

Fibrinous inflammation occurs when vascular leakage is large enough for fibrinogen to pass into the tissue, as in uraemic pericarditis. Fibrin is normally cleared by fibrinolysis. When it persists, macrophages and fibroblasts grow into it and it is organised into scar tissue, which may cause adhesions or constrictive pericarditis.

Option by option

  • A. Formation of caseating granulomas

    Caseating granulomas occur in tuberculosis, not in uraemic pericarditis.

  • B. Liquefactive necrosis with abscess formation

    Abscess formation with liquefaction follows pyogenic bacterial infection, which is not the issue here.

  • C. Organisation into fibrous adhesions between the pericardial layers (correct)

    Correct. Unresolved fibrin is organised into fibrous tissue, producing adhesions.

  • D. Complete resolution irrespective of fibrinolysis

    Resolution depends on removal of fibrin by fibrinolysis, so it is not automatic if fibrin persists.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, Organisation into fibrous adhesions between the pericardial layers. Fibrinous inflammation occurs when vascular leakage is large enough for fibrinogen to pass into the tissue, as in uraemic pericarditis.

Why is "Formation of caseating granulomas" not the answer?

Caseating granulomas occur in tuberculosis, not in uraemic pericarditis.

Why is "Liquefactive necrosis with abscess formation" not the answer?

Abscess formation with liquefaction follows pyogenic bacterial infection, which is not the issue here.

Why is "Complete resolution irrespective of fibrinolysis" not the answer?

Resolution depends on removal of fibrin by fibrinolysis, so it is not automatic if fibrin persists.

What concept does this question test?

It tests Inflammation: fibrinous exudate in Pathology. Fibrin is normally cleared by fibrinolysis. When it persists, macrophages and fibroblasts grow into it and it is organised into scar tissue, which may cause adhesions or constrictive pericarditis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Inflammation: fibrinous exudate?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.