Heart diseases

Question 1

what ages are mainly affected by acute rheumatic fever

Answer 1

5-15 y

Question 2

major criteria for rheumatic fever

Answer 2

Joint (migratory poly arthritis)
Oh my heart (active carditis)
Nodules (subq)
Erythema marginatum (annular and non-pruritic)
Sydenham’s chorea - saint Vitus dance - involuntary, jerky movements involving head and arms

Question 3

minor criteria for rheumatic fever

Answer 3

fever >/= 101.3 or 38.5C
arthralgia (joint pain)
increased ESR, CRP, leukocytosis
EKG - prolonged PR interval

Question 4

how to diagnose rheumatic fever

Answer 4

2 major or 1 major + 2 minor

needs supporting evidence of GAS (positive throat culture, rapid strep test, elevated strep AB titers)

Question 5

tx rheumatic fever

Answer 5

Aspirin 2-6 weeks + taper
ABX (IM PCN B benzathine abx of choice)

Question 6

another name for Kawasaki syndrome

Answer 6

mucocutaneous lymph node syndrome

Question 7

what is Kawasaki syndrome

Answer 7

medium and small vessel necrotizing vasculitis including the coronary arteries

Question 8

what age, race, gender are commonly affected by Kawasaki

Answer 8

3 mos - 5 years
boys
asian descent

Question 9

mnemonic for kawasaki

Answer 9

Warm + CREAM
conjunctivitis - b/l nonexudative
Rash - polymorphous
extremity changes - edema, erythema, desquamation of plasma and had soles
adenopathy - cervical
mucositis - strawberry tongue, lip swelling or tissues

warm - high grade fever at least 5 days

Question 10

how to dx kawasaki

Answer 10

high grade fever at least 5 days + 4 of mnemonic

Question 11

complications kawasaki

Answer 11

coronary vessel arteritis - coronary artery aneurysms, MI –> order EKG and echo

Question 12

what should you always order for Kawasaki to look for complications

Answer 12

echo and EKG

Question 13

tx kawasaki

Answer 13

IVIG + aspirin