CARDIOVASCULAR DISEASES

Question 1

a rare but serious bacterial infection in your blood. It causes severe symptoms that get worse fast, including muscle pain, cold hands and feet, lethargy, chills, fever, a rash and more

Answer 1

meningococcemia

Question 2

causative agent of meningococcemia

Answer 2

neisseria meningitidis

Question 3

how many serogroups are there in the capsular polysaccharide of n. meningitidis?

Answer 3

13 (A, B, C, D, 2gE, H, I, K, L, W135, X, Y, Z)

Question 4

which 5 n. meningitidis serogroups are most frequent and vaccine preventable?

Answer 4

A, B, C, W135, Y

Question 5

which n. meningitidis serogroup capsule is immunologically identical to E.coli K-1?

Answer 5

serogroup B

Question 6

which n. meningitidis OMP define the serotype?

Answer 6

Class 2 and 3

Question 7

which n.meningitidis OMP defines subtype?

Answer 7

class 1

Question 8

true or false: meningococci is exclusively a human pathogen

Answer 8

true

Question 9

common habitat or meningococci

Answer 9

oropharynx or nasopharynx

Question 10

mode of transmission of n. meningitidis

Answer 10

• contact
• droplets

Question 11

• follows URT infection
• multi-organ disease, consumptive, coagulopathy, petechial or purpuric rash
  deficiency in complement C5 to C8 predisposes to infection

Answer 11

meningococcemia

Question 12

• initially pink maculopapular lesions
• later evolves into non-blanching petechial rah in trunk and lower extremities

Answer 12

acute meningococcemia

Question 13

• most severe form of meningococcemia
• high fever, shock, widespread pupura, intravascular coag, thrombocytopenia, and adrenal insufficiency
• hemorrhagic destruction of the adrenal glands

Answer 13

waterhouse-friderichsen syndrome

Question 14

diagnostic procedure for meningococcemia

Answer 14

• CSF profile
• gram stain

Question 15

treatment for meningococcemia

Answer 15

• penicillin G

Question 16

vaccines for meningcoccemia

Answer 16

• MPSV4 polysacchariade vaccine
• MCV4 conjugate vaccine

Question 17

MPSV4 vs MCV4
- quadrivalent
- for elderly > 55

Answer 17

MPSV4

Question 18

MPSV4 vs MCV4
- quadrivalent + diptheria toxin mutant
- 2-55 y/o

Answer 18

MCV4

Question 19

abnomal, delayed, often recurrent autoimmune reaction to Group A beta hemolytic streptococcal pharyngitis involving the joints, skin, brain, serous surface, and heart

Answer 19

rheumatic fever

Question 20

rheumatic fever attacking and reccurence often results to

Answer 20

rheumatic heart disease

Question 21

true or false: rheumatic fever is the most common cause of acquired disease in children more than 5 y/o in the ph

Answer 21

true

Question 22

also classified as a post-infectious connective tissue disease

Answer 22

rheumatic fever

Question 23

prevalence rate of rheumatic fever in the PH pero 1000

Answer 23

0.1 to 22 per 1000

Question 24

percentage of recurrence of rheumatic fever / streptococcal infection in the PH

Answer 24

14.6%

Question 25

SS:

• streptococcal pharyngitis 1-5 weeks before onset of symptoms
• pallor, malaise, easy fagitability, epitaxis, and abdominal pain

Answer 25

rheumatic fever

Question 26

what criteria is used for the diagnosis of rheumatic fever?

Answer 26

jones criteria

Question 27

• most serious cause of morbidity and accounts for most of the mortality encountered during the acute stage of the disease

SS:
- tachycardia
- heart murmur of valvulitis
- pericarditis
- cardiomegaly
- CHF

Answer 27

carditis

Question 28

• most common of the major manifestations
• involves large joints
• often more than one joint, simultaneously or in succession

Answer 28

polymigratory arthritis

Question 29

• non-pruritic, serpiginous or annular erythmatous rashes, most prominent on the trunk and the inner proxiaml portion of the extremities
• never seen on the face

Answer 29

erythema marginatum

Question 30

found symmetrically, singly or in clusters on the extensor surfaces of both large or small joints, over the scalp or along the spine

Answer 30

subcutaneous nodules

Question 31

begins with emotional lability and personality changes, and whill be replaced by loss of motor coordination

Answer 31

sydenham’s chorea

Question 32

minor jones manifestations include?

Answer 32

• arthralgia
• fever
• elevated acute phase reactants
• prolonged PR interval

Question 33

true or false: in diagnosing using the jones criteria two MINOR manifestations & 1 MAJOR are stronger than 2 MAJOR manifestations

Answer 33

false - 2 MAJOR are always stronger

Question 34

___ and ____ cannot be used as a minor manifestation in the presence of arthritis or carditis respectively

Answer 34

arthralgia, prolonged PR

Question 35

laboratory exams for rheumatic fever

Answer 35

• acute phase: ESR, CRP
• strep infection: ASO, throat culture
• cardiac: ECG, chest x-ray, and 2D ECHO

Question 36

what is the primary prevention for rheumatic fever?

Answer 36

• eradication of pharyngitis
• prevention of development of rheumatic fever

meds:
- oral penicillin
- eythromycin
- benzanthine penicillin

Question 37

what is the secondary prevention for rheumatic fever?

Answer 37

• benzanthine benzyl penicillin
• penicillin V
• erythromycin

Question 38

duration of secondary prophylaxis:

rheumatic fever without carditis

Answer 38

minimum 5 years or until 21 years

Question 39

duration of secondary prophylaxis:

rheumatic fever with carditis but no residual heart disease

Answer 39

minimum 10 years or well into adulthood

Question 40

duration of secondary prophylaxis:

rheumatic fever with carditic and residual heart disease

Answer 40

atleast 10 years since last episode and at least until 40 years, SOMETIMES lifelong