Rheumatic Fever Flashcards
1
Q
Non-suppurative infections of Group A strep
A
- scarlet fever
- impetigo
- pharyngitis
- cellulitis
- TSS
2
Q
Suppurative infectious of Group A streo
A
- tonsillopharyngeal cellulitis
- otitis media
- sinusitis
- necrotizing fasciitis
- streptococcal bacteremia
- meningitis/ brain abscess
- myositis
- pyoderma
3
Q
Describe the pathogenesis of rheumatic fever
A
Molecular mimicry between strep M protein and myosin
- cross reaction to laminin in the valvular basement membrane
- T cell activation and cytokine production
- starts as oedema and fibrinoid deposition
- later an Aschoff nodule develops
- myocarditis and endocarditis
4
Q
Main target in Rheumatic fever
A
Mitral valve
5
Q
Major Jones criteria
A
- carditis
- arthritis (large joint)
- chorea
- subcutaneous nodules
- erythema marginatum
6
Q
Minor Jones criteria
A
- arthralgia
- fever
- elevation of acute-phase reactants
- first degree heart block
7
Q
How many of each criteria do you need to diagnose RHF
A
2 majors
1 major, 2 minors
and revent strep infection
8
Q
Other signs associated with Rheumatic fever
A
- epistaxis
- acute appendicitis
- clubbing
- splenomegaly
- PANDAS
9
Q
Differential diagnoses for RHF
A
- fever and arthritis
- juvenile rheumatoid arthritis
- infective endocarditis
- sickle cell anaemia
- myocarditis
- post strep reactive arthritis
10
Q
Is RHF a notifiable disease?
A
YES
11
Q
Treatment of an acute attack of RHF
A
- no physical exercise for 2-3 months
- 10 days of penicillin
- no asprin for carditis
- diuretics and ACE inhibitors
- valve replacement
12
Q
Prevention strategies for RHF
A
- treat sore throats aggressively in patients with previous RF
- secondary prophylaxis with monthly IM Benzathine penicillin
13
Q
Duration of prophylaxis for patient without proven carditis
A
- 5 years after last attack or until 18 years
14
Q
Duration of prophylaxis for patient with carditis
A
- 10 years or at least until 25 years
15
Q
Duration of prophylaxis for patient with severe valvular disease or valve surgery
A
Lifelong
