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RAA > RAA > Flashcards

RAA Flashcards

1
Q

Def

A

Afectiune inflamatorie acuta nesupurativa a tes comjunctiv

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2
Q

Clinic perioada de latenta?
Lez inflam afecteaza
Care e importanta cea mai mare?

A

Dupa 3 saptamani de la infect faringiana cu streptococ b hemolitic grup A
Lez inflam :articulatii,inima tegum tes celular subcut si SNC
Importanta e afectarea cardiaca prin gibroza la niv ap valvular

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3
Q

Epidemiologie
Fact economic/mediu:
Fact bacteriologic
Fact gazda

A

A. conditii de viata malnutritia
B.streptococ b hem gr A
C. Vr 5-15 ani predisp genetica

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4
Q

Etiopatogenie de ce??

A

Infect la niv cailor resp sup in antecedente cu strepc b hem gr A

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5
Q

Argumente:pt etiologia raa

A

1 faringita streptococica in antec .per latenta 3-6 sapt

2.titru crescut al Ac impotriva unor antigene streptococice

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6
Q

Cum previi recurentele si RAA?

A

Trat antibiotic contra inf strept

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7
Q

Tabloul clinic caracterizat prin:

Manifestarile specifice?

A 
Tabloul infectios+
 Manifestarile specifice: 
Poliartrita
Cardita
Noduli subcutanati
Eritem marginat
Chorea minor
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8
Q

Tabloul nespecific

A

Febra
Altralgii
Epistaxis
Dur abdominala

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9
Q

Tb cl:Artrita reumatismala

A

Poliartrita migratorie
Artic mari rar mici
=>articulatii …cel putin
Eroarea:adm precoce a med AINS

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10
Q

Cardita reumatismala diag?

A 
Modificarea unui suflu cardiac organic
1suflu sistolic apical de regurgitare mitrala
2 sufl mezo.diastolic Carey Coombs
3.suflu diastolic de regurgitare aortica
Card marit.Rx
Eco frec pericardica revaraat pleural
Semne ICC
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11
Q

Clasific carditei

A

usoara: suflu/frec pericard faraaa cardiomegalie
Medie:cardiomeg faraaa ICC
Severa ICC

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12
Q

Nodulii subcutanati+ce semnifica

A

Nedurerosi
Mici
Neaderenti
Loc:tendoanele extensorilor, art pumnului,genunchiului,marg rotulei,scapula,procese spinoase vertebrale
Cardita reumatismala severa sau medie !!

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13
Q

Eritem marginat

A

Eruptie tranzitorie
Loc:zona prox a extremitatilor
Rashul e migrator nepruriginos acc de caldura
Semnif–cardita reumatismala

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14
Q

Chorea minor sydenham

A

Perioada de latenta de la infectie de luni
Afect SNC
Tabl cl treptat: nervozitate..miscari spasmotice involuntare necontrolate. …violente hipotonie musc
Se vindeca fara sechele in 1…3 luni

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15
Q

Investigatii paraclinice SPECIFICE!!??

A

Nu exista

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16
Q

Inv paraclinice

A

1.izolarea strept de grup a din cultura faringiana
2det Ac antistreptococici:ASLO(TEST SENSIBIL80%)
Anti deoxiy ribonuclease B (anti-DNAse B)
Antistreptokinase
Antihyaluronidase

Antecedente inf strept

17
Q

ASLO patologoc copil adult

A

Copil>320 Todd U

Adult>240todd U

18
Q

Paracl ce mai faci pt cord?

A

Ecg:creste PR
Ecocard:pancardita reumatismala

19
Q

DIAGNOSTICUL POZITIV!!!

A

Criteriile jones:cel putin 2 cr Majore sauuuu
1cr Major +2 minore
++++++antec de faringita streptococica

20
Q

Criterii Majore5

A 
1cardita
2poliartrita
3chorea minor
4 eritem marginat
5 noduli subcutanati
21
Q

Cr minore: cl si paracl

A

Clinic artralgii febra
Paraclinice cresterea react de faza acuta:PROT C reactiva,VSH
Creste PR pe ECG

22
Q

cum documentezi o infectie faring strept in antecedente

A

Cultura faring evid strept b hem gr A

Titrul crescut ac antistreptococici

23
Q

Dg pozitiv=sindrom poststreptococic minor( artrita reactiva)

A

Artrita si alte manif sistemice dupa o post infectie
Nu se intrunesc criteriile jones!!
Nu raspunde dramatic la trat antiinflam

24
Q

Evolutie vindecare?

A

In 6-12sapt( 1.5-3luni)

25
Q

Tratament specific?

A

Nu exista

26
Q

Obiectivele trat

A

1 trat inf strept
2trat atacului acut amelioram manifestarile
3 tr complicatiilor
4preventie

27
Q

Terapia antibiotica antistreptococica

A

Penicilina de elctie
Doza unica:1,2 mil U benzatin penicilina G im.
Daca e alergic->cefalosporina/eritromicina=10 zile

Profilaxia recurentelor reumatismale

28
Q

antistreptococicaterapia antiinflamatoare

A

ASPIRINA

Nivelul seric eficient 15-20mg/dl
Adulti+copii:100-125mg/kgc/zi ÷4 doze
DOAR CAND EXISTA DG SE INCEPE!!!
ameliorarea simt+ scad febrei se scade diza treptat 8 saptamani (2luni)

CORTICOSTEROIZI
pac cu cardita severa ICC
Prednison:1-2mg/kg/zi pana scd VSH apoi scazi pe o perioada de 2 sapt( dar dai si aspirina ,pe care inca o dai inca 2-3 sapt chiar daca intrerupi) apoi intrerupi

RAA (1 decks)

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