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File:IPLab3FibrinousPericarditis5.jpg|This high-power photomicrograph demonstrates fibrin (red amorphous material) on the surface of the pericardium (1). Note the reactive mesothelial cells on the surface of the pericardium (arrows) and the inflammatory cells within the pericardial tissue.
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== Virtual Microscopy ==
<peir-vm>IPLab3FibrinousPericarditis</peir-vm>
== Study Questions ==
* <spoiler text="What is the etiology of the fibrinous pericarditis that developed in this patient with renal failure?">Azotemia (an excess of nitrogen in the blood) is believed to be the cause of fibrinous pericarditis but the exact mechanism is unknown.</spoiler>
* <spoiler text="What are some other possible causes for pericarditis?">These include:
* infection -- viral, bacterial (especially TB), or fungal;
* rheumatic fever
* systemic lupus erythematosus;
* scleroderma;
* myocardial infarction;
* trauma; and
* neoplasia.</spoiler>
* <spoiler text="From where does the fibrin come that produces fibrinous pericarditis?">Fibrinogen leaks out of the blood vessels as part of the inflammatory reaction. It is then converted to fibrin. A fibrinous exudate develops when the vascular leaks are large enough or there is a procoagulant stimulus (e.g., pericarditis).</spoiler>
* <spoiler text="What are the possible outcomes of this condition (fibrinous pericarditis)?">* The inflammatory reaction can progress and lead to tamponade (rare).
* The inflammatory reaction could subside and the fibrin would be lysed via the fibrinolytic system (most likely outcome).
* The fibrin could become organized and result in a fibrous connective tissue scar which could restrict cardiac function.</spoiler>
== Additional Resources ==
=== Reference ===
* [http://emedicine.medscape.com/article/156951-overview eMedicine Medical Library: Acute Pericarditis]
* [http://emedicine.medscape.com/article/1918879-overview eMedicine Medical Library: Dialysis Complications of Chronic Renal Failure]
* [http://www.merckmanuals.com/professional/cardiovascular_disorders/pericarditis/pericarditis.html Merck Manual: Pericarditis]
* [http://www.merckmanuals.com/professional/genitourinary_disorders/renal_failure/chronic_kidney_disease.html Merck Manual: Chronic Kidney Disease: Renal Failure]
=== Journal Articles ===
* Wood JE, Mahnensmith RL. [http://www.ncbi.nlm.nih.gov/pubmed/11208042 Pericarditis associated with renal failure: evolution and management]. ''Semin Dial'' 2001 Jan-Feb;14(1):61-6.
=== Images ===
* [{{SERVER}}/library/index.php?/tags/162-fibrinous_pericarditis PEIR Digital Library: Fibrinous Pericarditis Images]
* [http://library.med.utah.edu/WebPath/CVHTML/CVIDX.html#7 WebPath: Pericarditis]
== Related IPLab Cases ==
* [[IPLab:Lab 3:Acute Myocardial Infarction|Lab 3: Heart: Acute Myocardial Infarction]]
{{IPLab 3}}
[[Category:IPLab:Lab 3]]
