Term
| Examples of Acquired heart disease (6) |
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Definition
| Rheumatic Fever, Congestive Heart Failure, Hypertension, Hyperlipidemia, Endocarditis, Kawasaki Disease |
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Term
| Rheumatic Fever is what kind of condition? |
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Definition
| Diffuse inflammatory condition |
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Term
| Origin of Rheumatic Fever? |
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Definition
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Term
| What is a cause or Rheumatic Fever? |
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Definition
| untreated Strep infection |
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Term
| Manifestations of Rheumatic Fever? |
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Definition
| Arthritis, carditis, chorea, erythema, subcutaneous nodules |
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Term
| RF is a diffuse inflammatory condition most probably of autoimmune origine of the connective tissue, primarily of .... |
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Definition
| the heart, joints, subQ tissues, brain and blood vessels |
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Term
| The most serious complication of RF? What can it result in? |
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Definition
| Rheumatic heart disease**permanent damage to teh cardiac valves most commonly the mitral and aortic valves. |
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Term
| When does RF characteristically manifest? |
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Definition
| 2-6 wks after an untreated or partially treated group A beta hemolytic streptococcal infection of the upper respiratory tract. |
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Term
| Does the intial infection of RF/strep produce symptoms of pharyngitis? |
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Definition
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Term
| When does the manifestations of RF occur? |
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Definition
| during the acute febrile period (first 1-2 wks of illness) |
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Term
RF**
tender warm erythematous joints (elbow knees, ankles, wrists) |
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Definition
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Term
RF**
inflammation of the endocardium including the valves, myocardium and pericardium, may be subclinical and is usually dx by the development of a cardiac murmer, cardiac enlargement or failure, or a pericardial friction rub |
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Definition
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Term
| What is the most frequent manifestation of carditis? |
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Definition
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Term
| involuntary, purposeless jerky mmovements of the legs, arms and face, with speech impairment caused by CNS involvement |
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Definition
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Term
| red, painless skin lesions that start as flat or slightly raised macules, usually over the trunk. This usually spreads at the margins of the lesion with central clearing |
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Definition
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Term
| small, nontender lumps attached to the tendon sheaths of joints and on bony prominences. They occur only rarely in RF and are usually associated with... |
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Definition
| SubQ nodules ** severe carditis |
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Term
| most common manifestation of RF? |
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Definition
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Term
| Most serious manifestation and the major cause of mortality during botht the acute and chronic phases of RF? |
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Definition
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Term
| The major long-term consequence of RF? |
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Definition
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Term
| criteria that assist in making a dx of RX |
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Definition
| hx of previous RF, arthralgias (joint pain) w/out arthritis, fever, elevated acute phase reactants including C-reactive protein and erythrocyte sed rate and first degree AV block on teh ECG, (Have they had a recent strep infection?) |
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Term
| Major Manifestations of RF? (jones criteria) |
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Definition
| carditis, polyarthritis, chorea, erythema marginatum, subQ nodules. |
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Term
| Minor Manifestations of RF (jones criteria) |
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Definition
| Fever, Arthralgia, Elevated erythrocyte sed rate or positive C-reactive protein, prolonged p-r interval, supporting evidence of preceding strep infection: hx of recent scarlet fever, positive throat culture for group A strep |
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Term
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Definition
| eradication of the strep bacteria and tx of other symptoms (joint inflammation, CHF, chroea) |
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Term
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Definition
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Term
| Once dx is established, what is administered in presence of significant carditis to speed resolution of the inflammatory process? |
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Definition
| anti-inflammatory agents (aspirin or corticosteroids) |
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Term
| Children who have had RF (and valve dmage) require what to prevent recurrence? |
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Definition
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Term
| The child w/out cardiac complications should receive what? for how long? |
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Definition
| antibiotic prohylaxis for 5 years or through age 21-25 yrs- which ever is longer. |
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Term
| Children with rheumatic heart diseas should continue prophylaxis for how long? |
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Definition
| at least 10 years and at least until age 40 |
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Term
| also called mucocutaneous lymph node syndrome |
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Definition
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Term
| is an acute febrile exanthematous illness of children wtih a generalized vasculitis of unknown etiology. |
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Definition
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Term
| Kawasaki disease is a major cause of what in children in the US? |
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Definition
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Term
| Research suggests that KD is an ________ triggered by ____________ |
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Definition
| immune mediated vasculitis/an acute infection or by a bacterial toxin |
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Term
| KD is seen most frequently in what age children? |
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Definition
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Term
| KD has a peak incidence in US in what age children? |
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Definition
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Term
| KD has 3 phases.. Name them |
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Definition
| 1. acute phase 2. subacute phase 3.Convalescent phase |
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Term
| Acute phase of KD lasts how many days? |
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Definition
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Term
| Acute phase of KD is characterized by? |
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Definition
| a high fever that persists longer than 5 days (they need to see a dr.) |
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Term
| T or F: Fever during acute phase of KD should be treated with antibiotic tx? |
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Definition
| F: Unresponsive to antibiotic tx |
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Term
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Definition
| bilateral, nonpurulent conjunctivitis; changes in the mucous membranes (erythema, fissures and cracking of the lips; strawberry tongue); changes in the peripheral extremities such as swelling and erythema of palms and soles; generalized erythematous rash and enlarged cerivical lymph nodes; tachycardia and extreem irritability |
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Term
| The subacute phase of KD lasts how long? |
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Definition
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Term
| What happens during the subacute phase of KD? |
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Definition
| The fever disappears and most s/s resolve |
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Term
| What is the subacute phase of KD characterized by? |
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Definition
| continued irritability, anorexia, desquamation of the fingers and toes, arthritis and arthralgia and cardiovascular manifestations including CHF, dysrhythmias and the typpical coronary anerysms. |
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Term
| When does coronary aneurysm formation begin in KD? |
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Definition
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Term
| How will coronary artery involvement be detected in KD? |
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Definition
| bsaeline echocardiogram at dx w/ repeat studies during week 3 of the illness and again 1 month later |
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Term
| When does the final stage of KD begin? |
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Definition
| day 26 and lasts until the erythrocyte sed rate returns to normal and all signs of illness have disappeared. |
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Term
| What is common physical manifestation of KD in convalescent stage |
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Definition
| deep transverse grooves called Beau's lines in child's nails. |
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Term
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Definition
| Fever of 5 days duration in conjunction with at least 4 of the 5 primary clinical finding for acute phase. |
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Term
| In KD the WBC count along with sed rate and C-reactive protein are levated during which phase? |
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Definition
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Term
| ECG in acute phase of KD may demonstrate what? |
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Definition
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Term
| Platelets in KD are detected with what? |
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Definition
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Term
| Therapeutic management is directed toward what in KD? |
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Definition
| preventing or reducing the coronary artery damage from KD |
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Term
| What med would first be given for client with KD? |
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Definition
| High dose IV immune globulin in combo with aspirin w/10 days of fever onset (lower the prevalence of coronary artery abnormalities) |
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Term
| At DX of KD what is given? |
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Definition
| IVIG is given in a dosage of 2g/kg over a 10-12hr infusion w/ high dose asa therapy beginning |
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Term
| Initially dosage of the asa is what in KD? |
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Definition
| in the antiinflammatory range of 80-100mg/kg/day in 4 evenly divided doses until fever resolves. |
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Term
| Once fever is gone in KD what is given? |
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Definition
| dosage is reduced to an antiplatelet aggregation dose of 3-5mg/kg/day once daily and continued thr weeks 6-8 of the illness. |
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Term
| If coronary artery abnormalities are identified what will be done (KD)? |
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Definition
| dosage of 3-5mg/kg/day once daily indefinitely |
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Term
| What happens if child is unresponsive to KD therapy? |
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Definition
| Coticosteroids may be considereed |
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Term
| What is the most important aspect of therapeutic management of KD? Why? |
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Definition
| Strep prophylaxis- b/c damaged valves can become further damaged with repeated infections. Prophylaxis is lifeong if there is actual involvement. |
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Term
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Definition
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