P: Rheumatic Fever

Question 1

Cause of rheumatic fever:

Answer 1

Group A B-hemolytic strep

Question 2

Pathological findings in rheumatic fever

Answer 2

Aschoff and anti-sckow cells

Question 3

S&S of rheumatic fever

Answer 3

JONES

• Migratory polyarthritis
• Pancarditis + valvular
• subcutanous nodules
• Erythema Marginatum
• Sydenham chorea

Question 4

MC valvular abn in rheumatic fever

Answer 4

Mitral valve Regurge\prolapse (early) —> Stenosis

Question 5

When does (chorea and carditis) sx occur?

Answer 5

After months (1-8) of initial infection 
تطول

Question 6

Describe erythema marginatum

Answer 6

well defined boarder + central clearing

Painless

Question 7

What is minor criteria

Answer 7

PALE 
Pyrexia 38.5 and polyarthralgia 
Acute phase reactant ESR >60- CRP >30 
Leukocytosis 
ECG changes

Question 8

ecg changes in rheumatic fever

Answer 8

Prolonged PR

Question 9

How to diagnose Rheumatic fever

Answer 9

2 Major

1 Major + 2 minor

Question 10

Rheumatic fever inv:

Answer 10

Antistrepolysin O titer

Question 11

Mx of rheumatic fever

Answer 11

Eradication of GABHS: Penicillin V

Question 12

What to give in penicillin allergy

Answer 12

Cephalosporin (if NO anaphylaxis) - Macrolide (anaphylaxis)

Question 13

How to prevent recurrance

Answer 13

• 1ary prevention: Eradication

- 2ndary: IM Penicillin G every 4 weeks

Question 14

Ab prophylaxis regimen

Answer 14

Every 5 years or until 21: w\no carditis
Every 10 years or until 21: w\carditis - no valvular leison
Every 10 years or until 40: w\carditis & perminant valvular lesions