25. Rheumatic fever - etiology, pathogenesis, clinical presentation, evolution, treatment and prevention.

Question 1

what is the aetiology of rheumatic fever

Answer 1

Rheumatic fever is an autoimmune reaction which occurs 2-3 weeks after a pharyngeal infection & can lead to a inflammatory reaction in heart, joints & skin

Beta-hemolytic group A streptococci

Question 2

what is the symptoms for rheumatic heart disease

Answer 2

dyspnea
nocturnal dyspnea - mitra valve stenosis

joints: assymetric polyarthritis of the large joints 
 Skin:
Subcutaneous rheumatic nodules 
Erythema anulare rheumaticum
 CNS:
▪ Chrorea minor

Question 3

diagnoses for rheumatic fever

Answer 3

Jones criteria:
o Subcutaneous bleeding o Polyarthritis
o Erythemaanulare
o Chrorea
o Carditis

Antibodies against metabolic products of A-streptococci

Question 4

what is the treatment for rheumatic heart disease

Answer 4

PenicillinV / amoxicillin

penicillin v - epigastric distress, diarrhea, constipation

cephalosprins 1st gen - cephalexin

oral thrush or a new yeast infection.

Treatment against inflammation
o NSAIDS 
ibuprofen
chronic ibuprofen use has been found correlated with risk of hypertension[24] and myocardial infarction (heart attack)
 dyspepsia, 

Naproxen
heartburn,
ulcers and stomach bleeding