Nephrology: uraemic pericarditis: practice question

A General Medicine 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

General Medicine · Nephrology: uraemic pericarditis

Sample item

A 48-year-old man with end-stage kidney disease who missed several dialysis sessions has pleuritic chest pain and a pericardial friction rub. Urea is 210 mg/dL. Echocardiography shows a small effusion without tamponade. What is the best treatment?

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

The answer and the reasoning

B. Urgent intensive haemodialysis with minimal or no heparin

Uraemic pericarditis is an indication for dialysis, and it usually resolves with daily or intensified sessions. Heparin is minimised to avoid haemorrhagic effusion. Pericardiocentesis or a window is reserved for tamponade or an effusion that persists despite intensive dialysis.

Option by option

  • A. Intravenous thrombolysis

    Thrombolysis is contraindicated and would risk haemorrhagic effusion.

  • B. Urgent intensive haemodialysis with minimal or no heparin (correct)

    Correct. Removing uraemic toxins treats the cause, and heparin is limited to prevent haemopericardium.

  • C. Immediate pericardiocentesis

    Pericardiocentesis is needed only for tamponade, and none is present here.

  • D. Anticoagulation with therapeutic heparin

    Heparin increases the risk of bleeding into the pericardium.

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 General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Urgent intensive haemodialysis with minimal or no heparin. Uraemic pericarditis is an indication for dialysis, and it usually resolves with daily or intensified sessions.

Why is "Intravenous thrombolysis" not the answer?

Thrombolysis is contraindicated and would risk haemorrhagic effusion.

Why is "Immediate pericardiocentesis" not the answer?

Pericardiocentesis is needed only for tamponade, and none is present here.

Why is "Anticoagulation with therapeutic heparin" not the answer?

Heparin increases the risk of bleeding into the pericardium.

What concept does this question test?

It tests Nephrology: uraemic pericarditis in General Medicine. Heparin is minimised to avoid haemorrhagic effusion. Pericardiocentesis or a window is reserved for tamponade or an effusion that persists despite intensive dialysis.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Nephrology: uraemic pericarditis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.