Rheumatic fever Flashcards
What is rheumatic fever
a systemic immune response after Beta-hemolytic Strep of pharynx
Peak is 5-15 y/o but not common in US
What valves are rheumatic fever most likely to infect
- Mitral valve
- Aortic valve
- Tricuspid/pulmonary
What are minor criteria of rheumatic fever
CAFE P C- CRP elevated A- Arthralgia F- Fever E- ESR elevated P- Prolonged PR
What are the major manifestations of rheumatic fever
CANCER C- carditis A- arthritis N- nodules C- chorea E- erythema marginatum (R- rheumatic fever)
What are some common differentials for rheumatic fever
Rheumatoid arthritis osteomyelitis endocarditis meningitis SLE Lyme disease Sickle cell anemia
What diagnostic tests should you get for rheumatic fever
Echo ECG CRP or ESR CBC w/ diff ASO
What is Jones criteria for diagnosing rheumatic fever
2 major criteria OR
1 major and 2 minor criteria OR
3 minor criteria
What is the treatment for rheumatic fever
Supportive care (bed rest) Salicylates (ASA) Penicillin/Corticosteroids Patient education (oral health) Benzathine penicillin IM every 4 weeks to prevent recurrence
How long should you give secondary prophylaxis to someone with rheumatic fever
Without carditis: for 5 years or until 21
With carditis but no valve dz: 10 years or until 21
With carditis and valve dz: 10 years or until 40
What are some complications of rheumatic fever
rheumatic valve disease
HF, arrhythmias, pericarditis w/ effusion. rheumatic pneumonitis
Who can you refer peds patients to
ID
rheumatologist
cardiology
What is the major cause of CV disease in developing countries
Rheumatic heart disease (15% of HF in endemic countries)
How you you diagnose Rheumatic heart disease
TEE (check for mitral regurg)
How do you treat rheumatic heart disease
activity restrictions
prevent IE
treat complications
