CARDIOVASCULAR DISEASES Flashcards
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
meningococcemia
causative agent of meningococcemia
neisseria meningitidis
how many serogroups are there in the capsular polysaccharide of n. meningitidis?
13 (A, B, C, D, 2gE, H, I, K, L, W135, X, Y, Z)
which 5 n. meningitidis serogroups are most frequent and vaccine preventable?
A, B, C, W135, Y
which n. meningitidis serogroup capsule is immunologically identical to E.coli K-1?
serogroup B
which n. meningitidis OMP define the serotype?
Class 2 and 3
which n.meningitidis OMP defines subtype?
class 1
true or false: meningococci is exclusively a human pathogen
true
common habitat or meningococci
oropharynx or nasopharynx
mode of transmission of n. meningitidis
- contact
- droplets
- follows URT infection
- multi-organ disease, consumptive, coagulopathy, petechial or purpuric rash
deficiency in complement C5 to C8 predisposes to infection
meningococcemia
- initially pink maculopapular lesions
- later evolves into non-blanching petechial rah in trunk and lower extremities
acute meningococcemia
- most severe form of meningococcemia
- high fever, shock, widespread pupura, intravascular coag, thrombocytopenia, and adrenal insufficiency
- hemorrhagic destruction of the adrenal glands
waterhouse-friderichsen syndrome
diagnostic procedure for meningococcemia
- CSF profile
- gram stain
treatment for meningococcemia
- penicillin G
vaccines for meningcoccemia
- MPSV4 polysacchariade vaccine
- MCV4 conjugate vaccine
MPSV4 vs MCV4
- quadrivalent
- for elderly > 55
MPSV4
MPSV4 vs MCV4
- quadrivalent + diptheria toxin mutant
- 2-55 y/o
MCV4
abnomal, delayed, often recurrent autoimmune reaction to Group A beta hemolytic streptococcal pharyngitis involving the joints, skin, brain, serous surface, and heart
rheumatic fever
rheumatic fever attacking and reccurence often results to
rheumatic heart disease
true or false: rheumatic fever is the most common cause of acquired disease in children more than 5 y/o in the ph
true
also classified as a post-infectious connective tissue disease
rheumatic fever
prevalence rate of rheumatic fever in the PH pero 1000
0.1 to 22 per 1000
percentage of recurrence of rheumatic fever / streptococcal infection in the PH
14.6%
SS:
- streptococcal pharyngitis 1-5 weeks before onset of symptoms
- pallor, malaise, easy fagitability, epitaxis, and abdominal pain
rheumatic fever
what criteria is used for the diagnosis of rheumatic fever?
jones criteria
- 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
carditis
- most common of the major manifestations
- involves large joints
- often more than one joint, simultaneously or in succession
polymigratory arthritis
- 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
erythema marginatum
found symmetrically, singly or in clusters on the extensor surfaces of both large or small joints, over the scalp or along the spine
subcutaneous nodules
begins with emotional lability and personality changes, and whill be replaced by loss of motor coordination
sydenham’s chorea
minor jones manifestations include?
- arthralgia
- fever
- elevated acute phase reactants
- prolonged PR interval
true or false: in diagnosing using the jones criteria two MINOR manifestations & 1 MAJOR are stronger than 2 MAJOR manifestations
false - 2 MAJOR are always stronger
___ and ____ cannot be used as a minor manifestation in the presence of arthritis or carditis respectively
arthralgia, prolonged PR
laboratory exams for rheumatic fever
- acute phase: ESR, CRP
- strep infection: ASO, throat culture
- cardiac: ECG, chest x-ray, and 2D ECHO
what is the primary prevention for rheumatic fever?
- eradication of pharyngitis
- prevention of development of rheumatic fever
meds:
- oral penicillin
- eythromycin
- benzanthine penicillin
what is the secondary prevention for rheumatic fever?
- benzanthine benzyl penicillin
- penicillin V
- erythromycin
duration of secondary prophylaxis:
rheumatic fever without carditis
minimum 5 years or until 21 years
duration of secondary prophylaxis:
rheumatic fever with carditis but no residual heart disease
minimum 10 years or well into adulthood
duration of secondary prophylaxis:
rheumatic fever with carditic and residual heart disease
atleast 10 years since last episode and at least until 40 years, SOMETIMES lifelong
