Term
| Rheumatic Fever - criteria |
|
Definition
- Jones Criteria
J for joints (arthritis) – migrating polyarthritis
O like shape of the heart (carditis)
N for nodules (subcutaneous nodules)
E for erythema marginatum
S for Sydenham Chorea |
|
|
Term
|
Definition
A. Two major criteria - OR-
B. One major plus two minor criteria - PLUS -
C. evidence of previous streptococcal infection
so you need C+ (A or B) |
|
|
Term
| Evidence of previous streptococcal infection |
|
Definition
- recent scarlet fever
- raised antistreptolysin O (ASO) titer
- positive throat culture |
|
|
Term
|
Definition
- carditis
- arthritis
- chorea
- erythema marginatum
- subcutaneous nodules |
|
|
Term
|
Definition
- previous rheumatic fever
- arthralgia
- fever
- acute phase reactants
- first-degree atrioventricular block |
|
|
Term
|
Definition
- Present in 50% cases of RF
- “Sleeping” tachycardia is an early sign
- Mitral and aortic valves most commonly involved |
|
|
Term
|
Definition
- Most common manifestation of RF
- Pain, swelling and erythema
- Resolves within 1 week |
|
|
Term
| Rheumatic fever - tx and prevention |
|
Definition
Benzathine penicillin 1.2 mega units IM
Aspirin 75-100 mg/kg for 6-8 weeks
Steroids for severe carditis
Digoxin (used in heart failure), diuretics
Prevention with Benzathine Penicillin q 4 weeks. |
|
|
Term
|
Definition
Triphasic
Acute: 7 to 14 days
Subacute: 10 to 25 days
Convalescent: 21 to 60 days
- Unknown cause (New Haven coronavirus)
- winter and spring
- Median: 2.3 yrs, 80% less than 4
- lots of atypical presentation |
|
|
Term
| Kawasaki syndrome - acute phase (8) |
|
Definition
- Fever: sudden onset, spiking as high as 40 degree c (like 104), precedes other sns and sxs by 1 to 2 days, lasts more than 5 days (slide says 5 days)
- Irritability
- Bulbar Conjunctivitis: appears early; nonexudative and nonulcerative, just RED EYES
- Oropharnygeal erythema: red, cracked, fissured lips; “strawberry tongue”, and diffuse mouth erythema
- Rash: scarlitiniform (sand-paper like), morbilliform, macular and papular erythema, multiforme-like with target lesions, urticarial plaques, or pustular. Involvement of the perineum
- Lymphadenopathy
- Distal extremity edema and erythema (leading to desquamation)
- thrombocytosis (sometimes really high) and elevated ESR seen in 2nd week |
|
|
Term
| Kawasaki syndrome - Subacute phase |
|
Definition
| Desquamation of fingers and toes |
|
|
Term
| Kawasaki syndrome - complications |
|
Definition
- Cardiac: tachycardia, dysrhythmias, pericarditis, pericardial effusion, myocarditis, mitral or aortic insufficiency, and CHF.
****Coronary artery aneurysms in the 2nd week– MOST COMMON COMPLICATION (KNOW THIS!!!) |
|
|
Term
|
Definition
- IVIG 2 gm/kg as a single dose and high dose aspirin
- steroids occasionally needed for cases unresponsive to IVIG (w/ cardiac involvement) |
|
|
Term
|
Definition
| SYNCOPE w/ exertion or excitement, anger fear startle; cardiac arrest w/ exercise or excitement |
|
|
Term
|
Definition
| if exercise-induced, associated w/ chest pain, palpitations, or dyspnea, cardiac disease, positive family history, or if history suggests other illness |
|
|
Term
| Benign types of syncope (4) |
|
Definition
| vasovagal, orthostatic hypotension, hyperventilation, breath holding spells |
|
|
Term
|
Definition
| e.g. secondary to hunger, fear, fatigue, overcrowding, sight of blood) |
|
|
Term
|
Definition
| Sudden onset, or during exercise or while lying down |
|
|
Term
|
Definition
– migraine, orthostatic hypotension, hypoglycemia, drugs, hyperventilation or hysteria,
o Danger!! = SYNCOPE w/ exertion or excitement, anger fear startle; cardiac arrest w/ exercise or excitement |
|
|
Term
| QT should always be measured in |
|
Definition
| syncope, seizures, congenital deafness, near SIDs |
|
|
