1. A 45-year-old man presents with sudden-onset chest pain that worsens with inspiration and lying down. Electrocardiography (ECG) shows diffuse ST-segment elevation. Which of the following is the most likely diagnosis?
A. Acute myocardial infarction
B. Acute pericarditis
C. Acute aortic dissection
D. Acute pulmonary embolism
E. Acute myocarditis
2. A 60-year-old man with a history of malignancy presents with chest pain and fever. Echocardiography reveals a large pericardial effusion with evidence of cardiac tamponade. Which of the following is the most appropriate next step in management?
A. Initiate anti-inflammatory therapy
B. Perform pericardiocentesis
C. Perform surgical pericardial window
D. Initiate antibiotic therapy
E. Recommend palliative care
3. A 35-year-old woman with a history of systemic lupus erythematosus (SLE) presents with chest pain, fever, and pericardial friction rub. Which of the following is the most appropriate initial treatment?
A. Aspirin
B. Colchicine
C. Corticosteroids
D. Nonsteroidal anti-inflammatory drugs (NSAIDs)
E. Anticoagulation
4. A 55-year-old man with a history of end-stage renal disease on hemodialysis presents with chest pain and shortness of breath. Echocardiography reveals a large, loculated pericardial effusion. Which of the following is the most appropriate next step in management?
A. Initiate anti-inflammatory therapy
B. Perform pericardiocentesis
C. Perform surgical pericardial window
D. Initiate antifungal therapy
E. Recommend palliative care
5. A 60-year-old man with a history of rheumatoid arthritis presents with recurrent episodes of chest pain, fever, and pericardial friction rub. Which of the following is the most appropriate treatment?
A. Aspirin
B. Colchicine
C. Corticosteroids
D. Nonsteroidal anti-inflammatory drugs (NSAIDs)
E. Anticoagulation
6. A 45-year-old man with a history of recent viral illness presents with chest pain that worsens with inspiration and is relieved by leaning forward. ECG shows diffuse concave ST-segment elevation. Which of the following is the most likely diagnosis?
A. Acute pericarditis
B. Acute myocardial infarction
C. Acute aortic dissection
D. Acute pulmonary embolism
E. Acute myocarditis
7. A 55-year-old woman with a history of breast cancer presents with chest pain, shortness of breath, and hypotension. Echocardiography reveals a large pericardial effusion with evidence of cardiac tamponade. Which of the following is the most appropriate next step in management?
A. Initiate anti-inflammatory therapy
B. Perform pericardiocentesis
C. Perform surgical pericardial window
D. Initiate chemotherapy
E. Recommend palliative care
8. A 40-year-old man with a history of human immunodeficiency virus (HIV) infection presents with chest pain, fever, and pericardial friction rub. Which of the following is the most likely underlying cause?
A. Acute viral pericarditis
B. Bacterial pericarditis
C. Tuberculosis pericarditis
D. Malignant pericardial effusion
E. Radiation-induced pericarditis
9. A 65-year-old man with a history of chronic kidney disease presents with chest pain, shortness of breath, and hypotension. Echocardiography reveals a large pericardial effusion with evidence of cardiac tamponade. Which of the following is the most appropriate next step in management?
A. Initiate anti-inflammatory therapy
B. Perform pericardiocentesis
C. Perform surgical pericardial window
D. Initiate hemodialysis
E. Recommend palliative care
10. A 55-year-old man with a history of recent myocardial infarction presents with chest pain and pericardial friction rub. Which of the following is the most appropriate initial treatment?
A. Aspirin
B. Colchicine
C. Corticosteroids
D. Nonsteroidal anti-inflammatory drugs (NSAIDs)
E. Anticoagulation
11. A 45-year-old woman with a history of systemic lupus erythematosus (SLE) presents with chest pain, fever, and pericardial friction rub. Echocardiography reveals a large pericardial effusion. Which of the following is the most appropriate next step in management?
A. Initiate anti-inflammatory therapy
B. Perform pericardiocentesis
C. Perform surgical pericardial window
D. Initiate immunosuppressive therapy
E. Recommend palliative care
12. A 60-year-old man with a history of end-stage renal disease on hemodialysis presents with chest pain and shortness of breath. Echocardiography reveals a large, loculated pericardial effusion with evidence of cardiac tamponade. Which of the following is the most appropriate next step in management?
A. Initiate anti-inflammatory therapy
B. Perform pericardiocentesis
C. Perform surgical pericardial window
D. Increase the frequency of hemodialysis
E. Recommend palliative care
13. A 35-year-old man with a history of recent viral illness presents with chest pain that worsens with inspiration and is relieved by leaning forward. ECG shows diffuse concave ST-segment elevation. Which of the following is the most appropriate initial treatment?
A. Aspirin
B. Colchicine
C. Corticosteroids
D. Nonsteroidal anti-inflammatory drugs (NSAIDs)
E. Anticoagulation
14. A 50-year-old man with a history of malignancy presents with chest pain, fever, and pericardial friction rub. Echocardiography reveals a large, loculated pericardial effusion. Which of the following is the most appropriate next step in management?
A. Initiate anti-inflammatory therapy
B. Perform pericardiocentesis
C. Perform surgical pericardial window
D. Initiate chemotherapy
E. Recommend palliative care
15. A 60-year-old man with a history of recent myocardial infarction presents with chest pain, shortness of breath, and hypotension. Echocardiography reveals a large pericardial effusion with evidence of cardiac tamponade. Which of the following is the most appropriate next step in management?
A. Initiate anti-inflammatory therapy
B. Perform pericardiocentesis
C. Perform surgical pericardial window
D. Initiate anticoagulation
E. Recommend palliative care