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Acute pericarditis — USMLE Step 2 CK MCQ

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HardInternal MedicineAcute pericarditisUSMLE Step 2 CK

A 39-year-old Asian American man comes to the clinic because of chest discomfort or shortness of breath. History and focused examination are notable for pleuritic chest pain improved by leaning forward with diffuse ST elevation. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and initial testing support the clinical pattern described in the stem. Which of the following is the most appropriate pharmacotherapy?

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Correct answer: D — High-dose ibuprofen plus colchicine

The vignette describes Acute pericarditis, supported by pleuritic chest pain improved by leaning forward with diffuse ST elevation. High-dose ibuprofen plus colchicine is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: https://professional.heart.org/en/guidelines-and-statements#stage-9-order-19