At the autopsy of a 45-year-old Caribbean man who had rheumatic carditis, the pathologist noticed that the outer surface of the heart and the inner surface of the pericardial sac were covered with a "shaggy" whitish-yellow layer of stringy mater
The exudate apparently caused adhesions between the two layers of the pericardium, but nevertheless these two layers could be easily separated. The separated layers of the pericardium had a "bread and butter sandwich-like" appearance. This type of pericarditis is best classified as
A. serous
B. fibrinous
C. hemorrhagic
D. fibrous
E. purulent
B
The surface of the pericardial sac is covered with fibrin, and accordingly this form of pericarditis is classified as fibrinous. In serous pericarditis there are no visible surface deposits, but the pericardial cavity is filled with serous fluid. In hemorrhagic pericarditis the pericardial cavity contains blood. In fibrous pericarditis the two layers of pericardium are attached to one another by fibrous connective tissue, which encases the heart, thereby constricting it (constrictive pericarditis). In purulent pericarditis the pericardium is filled with pus, i.e., a viscous yellow fluid.
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Fill in the blank(s) with the appropriate word(s).
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