WBR0026: Difference between revisions
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|SubCategory=Cardiology, Cardiovascular | |SubCategory=Cardiology, Cardiovascular | ||
|Prompt=A 35-year-old female presents with fever, weakness and pleuritic chest pain. The pain is relieved by sitting up and leaning forward. Auscultation reveals friction rub. Her EKG is depicted below: <br> [[File:PtaDepressionPericarditis.png|700px]] <br> What is the best initial therapy in this patient? | |Prompt=A 35-year-old female presents with fever, weakness and pleuritic chest pain. The pain is relieved by sitting up and leaning forward. Auscultation reveals friction rub. Her EKG is depicted below: <br> [[File:PtaDepressionPericarditis.png|700px]] <br> What is the best initial therapy in this patient? | ||
|Explanation= | |Explanation=This patients presentation is classic for acute pericarditis. NSAIDs, such as ibuprofen, naproxen or indomethacin, are the best initial therapy for acute pericarditis. Management requires treatment for the underlying cause. The majority of cases, the specific cause of pericarditis is not identified, therefore they are assumed to be caused by Coxsackie B virus and treated with NSAIDs. Colchicine has been proved to decreased the recurrences. | ||
|AnswerA=Colchicine | |AnswerA=Colchicine | ||
|AnswerAExp=Colchicine may be used to prevent recurrences. | |AnswerAExp=[[Colchicine]] may be used to prevent recurrences. | ||
|AnswerB=NSAIDs | |AnswerB=NSAIDs | ||
|AnswerBExp=NSAIDs is the correct answer. | |AnswerBExp=NSAIDs is the correct answer. NSAIDs, such as ibuprofen, naproxen or indomethacin, are the best initial therapy for acute pericarditis. | ||
|AnswerC=Morphine | |AnswerC=Morphine | ||
|AnswerCExp=Morphine is not the first drug of choice for acute pericarditis. | |AnswerCExp=[[Morphine]] is not the first drug of choice for acute pericarditis. | ||
|AnswerD=Prednisone | |AnswerD=Prednisone | ||
|AnswerDExp=Oral prednisone is used in acute pericarditis in addition to NSAIDs when pain persists, but is not the best initial therapy to use. | |AnswerDExp=Oral [[prednisone]] is used in acute pericarditis in addition to NSAIDs when pain persists, but is not the best initial therapy to use. | ||
|AnswerE=Diuretics | |AnswerE=Diuretics | ||
|AnswerEExp=Diuretics are used in the initial management of patients with chronic constrictive pericarditis, prior to surgical management. | |AnswerEExp=[[Diuretics]] are used in the initial management of patients with chronic constrictive pericarditis, prior to surgical management. | ||
|EducationalObjectives= NSAIDs, such as indomethacin and aspirin, are the best initial therapy for acute pericarditis. | |||
Colchicine decreases recurrences | |||
|References=References: Master the Boards for Step 2CK, 2013 edition, page 99 | |||
|RightAnswer=B | |RightAnswer=B | ||
|WBRKeyword=NSAIDs, Pericarditis, | |||
|Approved=Yes | |Approved=Yes | ||
}} | }} | ||
Revision as of 20:56, 15 March 2014
| Author | PageAuthor::Raviteja Reddy Guddeti MBBS, Aarti Narayan MBBS (Reviewed by Gonzalo Romero) |
|---|---|
| Exam Type | ExamType::USMLE Step 2 CK |
| Main Category | MainCategory::Pharmacology, MainCategory::Internal medicine |
| Sub Category | SubCategory::Cardiology, SubCategory::Cardiovascular |
| Prompt | [[Prompt::A 35-year-old female presents with fever, weakness and pleuritic chest pain. The pain is relieved by sitting up and leaning forward. Auscultation reveals friction rub. Her EKG is depicted below:  What is the best initial therapy in this patient?]] |
| Answer A | AnswerA::Colchicine |
| Answer A Explanation | [[AnswerAExp::Colchicine may be used to prevent recurrences.]] |
| Answer B | AnswerB::NSAIDs |
| Answer B Explanation | AnswerBExp::NSAIDs is the correct answer. NSAIDs, such as ibuprofen, naproxen or indomethacin, are the best initial therapy for acute pericarditis. |
| Answer C | AnswerC::Morphine |
| Answer C Explanation | [[AnswerCExp::Morphine is not the first drug of choice for acute pericarditis.]] |
| Answer D | AnswerD::Prednisone |
| Answer D Explanation | [[AnswerDExp::Oral prednisone is used in acute pericarditis in addition to NSAIDs when pain persists, but is not the best initial therapy to use.]] |
| Answer E | AnswerE::Diuretics |
| Answer E Explanation | [[AnswerEExp::Diuretics are used in the initial management of patients with chronic constrictive pericarditis, prior to surgical management.]] |
| Right Answer | RightAnswer::B |
| Explanation | [[Explanation::This patients presentation is classic for acute pericarditis. NSAIDs, such as ibuprofen, naproxen or indomethacin, are the best initial therapy for acute pericarditis. Management requires treatment for the underlying cause. The majority of cases, the specific cause of pericarditis is not identified, therefore they are assumed to be caused by Coxsackie B virus and treated with NSAIDs. Colchicine has been proved to decreased the recurrences. Educational Objective: NSAIDs, such as indomethacin and aspirin, are the best initial therapy for acute pericarditis.
Colchicine decreases recurrences |
| Approved | Approved::Yes |
| Keyword | WBRKeyword::NSAIDs, WBRKeyword::Pericarditis |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |