ARF (Acute Rheumatic Fever)

Question 1

J❤️nes Criteria (Major)

Answer 1

Joints = Polyarthritis
❤️Heart = Carditis
Nodule = Subcutaneous
Erythema Marginatum
Sydenham Chorea

Question 2

Minor Criteria

Answer 2

CAFE PAL
CRP - Arthralgia - Fever - ESR
Prolonged PR - Anamnesis of rheumatism - Leukocytosis

Question 3

Diagnosis

Answer 3

Culture of pharyngitis, positive anti-SLO
+ 2 major / Major + 2 minor

Question 4

Treatment

Answer 4

1. Treat strep Pen g 1.2mU
   Pen V 250-500 TID or BID
   Cephalexin 25mg/kg/dose BID
   Clindamycin 7mg/kg/dose TID
   Azithromycin 12mg/kg then 6mg/kg
2. Anti-inflammatory Corticosteroids, Aspirin, NSAID
3. Bed rest

Question 5

Prophylaxis

Answer 5

Pen 6.3.3 / 3-4w
Pen V 250 bid
If Carditis: Sulfadiazine 0.5-1g daily (27 kg)
Allergy: Macrolides

Question 6

Prophylaxis Duration

Answer 6

• w/o carditis: 5yr or until 21, whichever longer
• w/ carditis w/o residue: 10yr or until 21, whichever longer
• w/ carditis & residue: 10yr or until 40, whichever longer, stimes lifelong