Term
| What is acute rheumatic fever (ARF)? |
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Definition
| inflammatory dz dev. ~2-3 wks /p a pharyngeal infxn with GAS |
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Term
| What is the peak age of incidence? Which gender is it more common in? |
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Definition
| 5-15 yo, equal in men and women |
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Term
| What is usually the earliest sx of ARF? What does it affect? |
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Definition
| Arthritis - affects several joints in quick succession for a short time. Knees, ankles, and elbows most common |
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Term
| What is used to tx arthritis? |
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Definition
| salicylates or other anti-inflammatory meds |
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Term
| How does cardititis manifest as a consequence of ARF? |
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Definition
| Pericarditis, cardiomegaly, CHF, or new murmur |
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Term
| What type of murmur is heard in ARF? |
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Definition
| Mitral (most common) or aortic regurgitation |
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Term
| What is a neurologic consequence of ARF? |
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Definition
| Sydenham's chorea - purposeless nonrhythmic involuntary movements, mus. weakness, emotional disturbances |
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Term
| When does sydenham's chorea develop? |
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Definition
| Usually late - up to 8 mths after infxn |
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Term
| What dermatologic sign of ARF occur over bony prominence or near tendons? |
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Definition
| Subcutaneous nodules - small, painless, firm bumps |
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Term
| What dermatologic sign of ARF usually only occurs in pts with carditis and are often on the trunk or proximal limbs? |
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Definition
| erythema marginatum, non-pruritic rash w/ reddish pink border and pale center |
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Term
| What is the set of diagnostic criteria for ARF? |
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Definition
| Jones criteria - evidence of GAS, 2 major manifestations, or 1 major and 2 minor |
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Term
| Name the 5 major manifestations of the Jones criteria. |
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Definition
| 1) Carditis 2) Polyarthritis 3) Chorea 4) Erythema marginatum 5) Sub-q nodules |
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Term
| Name the 4 minor manifestations in the Jones criteria. |
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Definition
| 1) arthralgia 2) fever 3) elev. ESR or CRP 4) prolonged PR interval |
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Term
| What qualifies as evidence of GAS infxn? |
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Definition
| positive throat culture for GAS or (+) rapid strep test or elevated strep Ab titer |
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Term
| Name 3 exceptions to Jones criteria that are diagnostic for ARF. |
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Definition
| 1) Chorea 2) indolent carditis 3) recurrent rheumatic fever |
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Term
| Name 5 complications of ARF. |
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Definition
| 1) Rheumatic HD 2) congestive HD 3) Arrythmia 4) Pericarditis w/ effusion 5) Rheumatic pneumonitis |
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Term
| What is the drug of choice to tx ARF? |
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Definition
|
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Term
| what is secondary prevention of rheumatic fever? |
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Definition
| Continuous Ab prohylaxis to prevent recurrent RF - IM Benzathine penicillin G q 4 wks |
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Term
| What is the major cause of acquired heart disease in the world? |
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Definition
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Term
| When does Rheumatic heart disease occur? |
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Definition
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Term
| What valve is usually affected in Rheumatic heart disease? What murmur is a classic finding? |
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Definition
| Mitral more than aortic, mitral stenosis |
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