not standard ACS. — EECC MCQ

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Hard"For ACS treated with DESnot standard ACS.EECC

A patient has recurrent idiopathic pericarditis with CRP-positive flares despite colchicine and becomes glucocorticoid dependent. Infection and systemic autoimmune disease have been excluded. Which targeted treatment class is most appropriate?

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Correct answer: B — Interleukin-1 pathway inhibition

The best answer is “Interleukin-1 pathway inhibition”. Autoinflammatory recurrent pericarditis with colchicine resistance and steroid dependence responds to IL-1 blockade, which can permit steroid withdrawal and reduce recurrences. “Azathioprine maintenance immunosuppression” is less appropriate because thrombolysis does not target pericardial inflammation “High-dose intravenous immunoglobulin treatment” is less appropriate because dual antiplatelet therapy is not an anti-inflammatory disease-modifying regimen “Cyclophosphamide induction immunosuppression” is less appropriate because diuresis treats congestion rather than recurrent pericardial inflammation “Tumour-necrosis-factor pathway inhibition” is less appropriate because beta-blockade has no disease-specific anti-inflammatory action

Reference: 2025 ESC Guidelines for myocarditis and pericarditis. https://academic.oup.com/eurheartj/article/46/40/3952/8234483