Rheumatic Fever

Question 1

Which age group has the highest rate of acute rheumatic fever?

Question 4Select one:

a.
0 to 4 weeks

b.
4 - 52 weeks

c.
1 to 4 years

d.
5 to 14 years

Answer 1

5-14

Question 2

A 7 year old Tongan boy is diagnosed with rheumatic fever and after convalescing in hospital is sent home to continue prophylactic penicillin until he is 21 years old. What is the proven reliable method of preventing future attacks of rheumatic fever?

Question 3Select one:

a.
Intramuscular benzathine penicillin every 28 days

b.
Subcutaneous procaine penicillin fortnightly

c.
Intravenous benzyl penicillin twice weekly

d.
Oral phenoxymethyl penicillin twice daily

Answer 2

Intramuscular benzathine penicillin every 28 days

Question 3

Annual rates of acute rheumatic fever are highest in which group of NZ children?

Question 2Select one:

a.
Maori

b.
Pacifica

c.
European

d.
SE Asian

Answer 3

Pacifica

Question 4

A 9-year-old Samoan boy presents with a history of a sore throat one week ago, now resolved without treatment. Yesterday he was referred to hospital by his GP with a temperature of 39.5°C and a sore left hip for two days so that he is unable to weight bear. He has been taking NSAIDs. He has tenderness on palpation of the left inguinal region over the hip joint, and has limited extension of the left hip. His ESR is 70mm/hr. In hospital, an ultrasound scan revealed an effusion of the left hip, and a joint aspirate was performed which did not grow any bacteria. His Streptococcal antibody levels are very high, and higher than the ones obtained by the GP at the time of his sore throat.

WHICH ONE of the following is required for him to meet the NZ criteria for diagnosis of Rheumatic fever?

Question 1Select one:

a.
The patient already meets New Zealand criteria

b.
New major heart murmur

c.
Painful Osler nodes

d.
Erythema multiforme

Answer 4

The patient already meets New Zealand criteria