Rhematic Fever Flashcards

1
Q

What is rheumatic fever?

A

An autoimmune inflammatory disease affecting the heart, joints, CNS, skin, and subcutaneous tissues.

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2
Q

What causes rheumatic fever?

A

A delayed immune response to Group A streptococcal infection.

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3
Q

What is the latent period for rheumatic fever?

A

2-4 weeks after streptococcal infection.

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4
Q

What age group is most affected by rheumatic fever?

A

5-15 years.

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5
Q

Is rheumatic fever more common in boys or girls?

A

Equal, but chorea is more common in girls.

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6
Q

What is the role of molecular mimicry in rheumatic fever?

A

Antibodies against streptococcal antigens cross-react with human tissue antigens.

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7
Q

What are Aschoff nodules?

A

Proliferative lesions in rheumatic fever that heal by fibrosis.

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8
Q

What is the most common cardiac manifestation of rheumatic fever?

A

Carditis.

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9
Q

What is the characteristic rash in rheumatic fever?

A

Erythema marginatum.

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10
Q

What are subcutaneous nodules in rheumatic fever?

A

Painless, hard nodules over bony prominences.

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11
Q

What is Sydenham’s chorea?

A

A neurological manifestation of rheumatic fever characterized by involuntary movements.

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12
Q

What is the Jones Criteria?

A

Diagnostic criteria for rheumatic fever including major and minor manifestations.

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13
Q

What laboratory tests are used to diagnose rheumatic fever?

A

ASO titers, CRP, ESR.

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14
Q

What is the first-line treatment for rheumatic fever?

A

Penicillin to eradicate streptococcal infection.

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15
Q

What anti-inflammatory medications are used in rheumatic fever?

A

Aspirin and corticosteroids.

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16
Q

What is the primary prevention for rheumatic fever?

A

Prompt treatment of streptococcal infections.

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17
Q

What is secondary prevention for rheumatic fever?

A

Prophylactic antibiotics to prevent recurrence.

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18
Q

What is the most serious complication of rheumatic fever?

A

Chronic rheumatic heart disease.

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19
Q

What is the prognosis for rheumatic fever?

A

Good with early treatment, but risk of chronic heart disease with recurrence.

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20
Q

What is the role of echocardiography in rheumatic fever?

A

To detect subclinical carditis.

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21
Q

What is the difference between rheumatic arthritis and rheumatoid arthritis?

A

Rheumatic arthritis affects large joints, is migratory, and does not cause deformity.

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22
Q

What is the significance of a functional murmur in children?

A

It is usually benign and not associated with structural abnormalities.

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23
Q

What is the treatment for Sydenham’s chorea?

A

Haloperidol or valproic acid, along with anti-inflammatory treatment.

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24
Q

What is the role of corticosteroids in rheumatic fever?

A

Used in severe carditis to reduce inflammation.

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25
Q

What is the importance of family history in rheumatic fever?

A

Positive family history may indicate a genetic predisposition.

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26
Q

What is the significance of elevated ASO titers?

A

Indicates recent streptococcal infection.

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27
Q

What is the typical duration of rheumatic fever symptoms?

A

Symptoms can last for weeks to months, depending on severity.

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28
Q

What is the role of aspirin in rheumatic fever?

A

Reduces inflammation and pain in arthritis and carditis.

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29
Q

What is the risk of recurrence in rheumatic fever?

A

High without prophylactic antibiotics.

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30
Q

What is the impact of rheumatic fever on school performance?

A

Poor school performance may be seen in children with chorea.

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31
Q

What is the role of penicillin in rheumatic fever?

A

Eradicates streptococcal infection to prevent further immune response.

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32
Q

What is the significance of CRP in rheumatic fever?

A

Indicates inflammation and disease activity.

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33
Q

What is the role of ESR in rheumatic fever?

A

Measures the rate of erythrocyte sedimentation, indicating inflammation.

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34
Q

What is the typical presentation of rheumatic carditis?

A

Murmurs, cardiomegaly, pericarditis, and heart failure.

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35
Q

What is the treatment for heart failure in rheumatic fever?

A

Diuretics, ACE inhibitors, and beta-blockers.

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36
Q

What is the role of bed rest in rheumatic fever?

A

Recommended during acute phases to reduce cardiac workload.

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37
Q

What is the significance of a positive throat culture in rheumatic fever?

A

Confirms recent streptococcal infection.

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38
Q

What is the role of prophylactic antibiotics in rheumatic fever?

A

Prevents recurrence and further cardiac damage.

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39
Q

What is the typical duration of prophylactic antibiotics?

A

Often continued until adulthood or for at least 5 years after the last episode.

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40
Q

What is the role of surgery in rheumatic fever?

A

Valve repair or replacement in severe chronic rheumatic heart disease.

41
Q

What is the significance of a history of sore throat in rheumatic fever?

A

Often precedes the onset of rheumatic fever by 2-4 weeks.

42
Q

What is the role of NSAIDs in rheumatic fever?

A

Used for pain and inflammation in arthritis.

43
Q

What is the significance of a prolonged PR interval in rheumatic fever?

A

Indicates carditis and conduction abnormalities.

44
Q

What is the role of antistreptolysin O (ASO) titers?

A

Measures antibodies against streptolysin O, indicating recent streptococcal infection.

45
Q

What is the significance of a history of scarlet fever in rheumatic fever?

A

Indicates recent Group A streptococcal infection.

46
Q

What is the role of echocardiography in chronic rheumatic heart disease?

A

Assesses valve damage and guides treatment.

47
Q

What is the significance of a history of rheumatic fever in a patient with heart disease?

A

Indicates possible chronic rheumatic heart disease.

48
Q

What is the role of patient education in rheumatic fever?

A

Emphasizes the importance of adherence to prophylactic antibiotics.

49
Q

What is the significance of a family history of rheumatic fever?

A

May indicate a genetic predisposition to the disease.

50
Q

What is the role of public health measures in rheumatic fever?

A

Focuses on early detection and treatment of streptococcal infections to prevent rheumatic fever.

51
Q

What is the role of streptococcal pyrogenic exotoxins in rheumatic fever?

A

They contribute to the immune response and inflammation.

52
Q

What is the significance of a history of impetigo in rheumatic fever?

A

Indicates a possible streptococcal skin infection.

53
Q

What is the role of genetic factors in rheumatic fever?

A

Certain HLA types may increase susceptibility.

54
Q

What is the role of cytokines in rheumatic fever?

A

They mediate the inflammatory response.

55
Q

What is the significance of a history of rheumatic fever in siblings?

A

Indicates a possible genetic or environmental risk factor.

56
Q

What is the role of antistreptococcal antibodies in rheumatic fever?

A

They cross-react with human tissues, causing damage.

57
Q

What is the significance of a history of rheumatic fever in parents?

A

May indicate a familial predisposition.

58
Q

What is the role of complement activation in rheumatic fever?

A

Contributes to tissue damage and inflammation.

59
Q

What is the significance of a history of rheumatic fever in a patient with arthritis?

A

May indicate rheumatic arthritis.

60
Q

What is the role of T cells in rheumatic fever?

A

They play a role in the autoimmune response.

61
Q

What is the significance of a history of rheumatic fever in a patient with chorea?

A

May indicate Sydenham’s chorea.

62
Q

What is the role of B cells in rheumatic fever?

A

They produce antibodies that cross-react with tissues.

63
Q

What is the significance of a history of rheumatic fever in a patient with carditis?

A

May indicate chronic rheumatic heart disease.

64
Q

What is the role of macrophages in rheumatic fever?

A

They contribute to inflammation and tissue damage.

65
Q

What is the significance of a history of rheumatic fever in a patient with erythema marginatum?

A

May indicate active rheumatic fever.

66
Q

What is the role of neutrophils in rheumatic fever?

A

They contribute to the inflammatory response.

67
Q

What is the significance of a history of rheumatic fever in a patient with subcutaneous nodules?

A

May indicate active rheumatic fever.

68
Q

What is the role of dendritic cells in rheumatic fever?

A

They present antigens to T cells, initiating the immune response.

69
Q

What is the significance of a history of rheumatic fever in a patient with a heart murmur?

A

May indicate rheumatic carditis.

70
Q

What is the role of endothelial cells in rheumatic fever?

A

They are targets of the autoimmune response.

71
Q

What is the significance of a history of rheumatic fever in a patient with pericarditis?

A

May indicate rheumatic carditis.

72
Q

What is the role of fibroblasts in rheumatic fever?

A

They contribute to fibrosis in chronic lesions.

73
Q

What is the significance of a history of rheumatic fever in a patient with myocarditis?

A

May indicate rheumatic carditis.

74
Q

What is the role of collagen in rheumatic fever?

A

It is a target of the autoimmune response.

75
Q

What is the significance of a history of rheumatic fever in a patient with endocarditis?

A

May indicate rheumatic carditis.

76
Q

What is the role of elastin in rheumatic fever?

A

It is a target of the autoimmune response.

77
Q

What is the significance of a history of rheumatic fever in a patient with valvular heart disease?

A

May indicate chronic rheumatic heart disease.

78
Q

What is the role of proteoglycans in rheumatic fever?

A

They are targets of the autoimmune response.

79
Q

What is the significance of a history of rheumatic fever in a patient with atrial fibrillation?

A

May indicate chronic rheumatic heart disease.

80
Q

What is the role of glycosaminoglycans in rheumatic fever?

A

They are targets of the autoimmune response.

81
Q

What is the significance of a history of rheumatic fever in a patient with mitral stenosis?

A

May indicate chronic rheumatic heart disease.

82
Q

What is the role of laminin in rheumatic fever?

A

It is a target of the autoimmune response.

83
Q

What is the significance of a history of rheumatic fever in a patient with aortic regurgitation?

A

May indicate chronic rheumatic heart disease.

84
Q

What is the role of fibronectin in rheumatic fever?

A

It is a target of the autoimmune response.

85
Q

What is the significance of a history of rheumatic fever in a patient with tricuspid regurgitation?

A

May indicate chronic rheumatic heart disease.

86
Q

What is the role of integrins in rheumatic fever?

A

They mediate cell-matrix interactions.

87
Q

What is the significance of a history of rheumatic fever in a patient with pulmonary hypertension?

A

May indicate chronic rheumatic heart disease.

88
Q

What is the role of selectins in rheumatic fever?

A

They mediate leukocyte adhesion to endothelial cells.

89
Q

What is the significance of a history of rheumatic fever in a patient with heart failure?

A

May indicate chronic rheumatic heart disease.

90
Q

What is the role of cadherins in rheumatic fever?

A

They mediate cell-cell adhesion.

91
Q

What is the significance of a history of rheumatic fever in a patient with arrhythmias?

A

May indicate chronic rheumatic heart disease.

92
Q

What is the role of immunoglobulins in rheumatic fever?

A

They mediate the autoimmune response.

93
Q

What is the significance of a history of rheumatic fever in a patient with conduction abnormalities?

A

May indicate chronic rheumatic heart disease.

94
Q

What is the role of complement receptors in rheumatic fever?

A

They mediate complement activation.

95
Q

What is the significance of a history of rheumatic fever in a patient with pericardial effusion?

A

May indicate rheumatic carditis.

96
Q

What is the role of Fc receptors in rheumatic fever?

A

They mediate antibody-dependent cellular cytotoxicity.

97
Q

What is the role of toll-like receptors in rheumatic fever?

A

They recognize pathogen-associated molecular patterns.

98
Q

What is the role of cytokines in chronic rheumatic heart disease?

A

They contribute to ongoing inflammation and fibrosis.