Acute rheumatic fever

Question 1

Causative at

Answer 1

Group A beta hemolytic streptococci

Question 2

Most commin cause of heart disease in children of developing countries

Answer 2

RHD

Question 3

HLA Class II alleles thar associated with susceptibility

Answer 3

HLA-DR7

HLA-DR4

Question 4

Most common manifestations

Answer 4

Carditis

Polyarthritis

Question 5

Latent Period from infecrion to SSx

If with Chorea and indolent carditis

Answer 5

3 weeks

6 months chorea indolent carditisC

Question 6

Hallmark of rheumatic carditis

Answer 6

Valvular damage

Question 7

Most comminlt affected valve

Answer 7

Mitral valvr

Question 8

Character of joint. Involvement

Answer 8

Migratory
Adymmetric
Large joints

Question 9

Sydenham’s chorea resovles in _ weeks

Answer 9

6

Question 10

Pink macules that clear centrally leaving a serpinginous spreading edge
Usually on trunk sometimes limbs
Never on the face

Answer 10

Erythema marginatum

Question 11

Painless small mobile lumps underlying skin over bony prominences particularly of hands, feet, elbows, occiput and occl vertebrae
Few days to 3 weeks
Delayed manifestation usually 2-3 weeks after onset of disease
Associated with caridtis

Answer 11

Subcutaneous nodes

Osler’s nodes are painful and in Infective Endocarditis

Question 12

Titer for strep infection

Answer 12

Anti streptolysin O

Anti DNase B

Question 13

JONES criteria

mAjor

Answer 13

Major JONES
Joints artheitos
O=❤️ Carditis 
n subcutaneous nodes
E erythema marginatum
Sydenham chorea

Question 14

JONES MINOR

Answer 14

cafepal

CRP
Arthralgia 
Fever 
ESR 
Prolonged PR interval 
Previous fever or RHD
Leukocyte count

Question 15

Ceiteria for those withour recurrent RHEUMATIC FEVER

Answer 15

2 major

OR

1 major, 2 minor + evidence of group A

Question 16

Recurrent atrack of patient without RHD

Answer 16

2 major
OR
1 major + 2 minor
Evidence

Question 17

Recurrent attack of rheumatic fever in patient with RHD

Answer 17

2 minor

Evidence of GABHS

Question 18

Evidence of GABHS

Answer 18

Throat swab
Rapid antigen test for GAB
Recent scarlet fever
Anti strepltilysin O

Question 19

Antibiotics

Answer 19

Penicillin V 500mg BID PO 10 days
Amoxicillin 10 days
Single IM benzathine Pen G 1.2 M units

Alt erythromycin 250mg BID

Question 20

Aspirin dose

Answer 20

4-8g/day dicided into 4-5 doses for 2 weeks

Naproxen 10-20mg/kg as alternative

Question 21

CHorea refractory

Answer 21

IVIG

Question 22

Inflammatory markers normal after

Answer 22

4-6 weeks

Question 23

Repeat 2D echo when

Answer 23

1 month

Question 24

Repeat strep detection if initially negative

Answer 24

10-14 d

Question 25

Long term prophylaxis rheumatic fever eithout carditis

Answer 25

5 years from last attack or 21

Question 26

RF with carditis no VHD

Answer 26

10 years or up to 21

Question 27

RF eith persostent VHD

Answer 27

10 years or jntil 40 sometimes lifetime

Question 28

Valvular surgery

Answer 28

Lifetime

Question 29

Prophylaxis drugs

Answer 29

Benzathin Pen G 1M Q4 weeks 1.2MU
2/3weeks if high rosk

ORAL Pen V 250mg less effective

Question 30

Most widely accepted theroy is

Answer 30

Molecular mimicry

Question 31

Acute RF going to Rhd

Answer 31

60-%

Question 32

Polyarthritis

CSitis

Answer 32

50-60% carditis

50-75% PSA

Question 33

Latent period from infectious to appearance of clinical fratuees

Answer 33

3 weeks (1-5wks)

Question 34

How many persent of ARF proceed to RHD

Answer 34

60%