Rheumatic Fever Flashcards

1
Q

How do they present?

A

2-3 weeks after throat infection

  • fever
  • poor appetite
  • weight loss
  • fever
  • painful joints
  • heart failure
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2
Q

Diagnosis

A
2 major OR 1 major and 2 minor 
Major 
- carditis 
- polyarthritis 
- syndenham chorea 
- erythema marginatum 
- subcutaneous nodules 

minor

  • increased PR interval on ECG
  • arthralgia
  • increased CRP, ESR, WBC
  • fever
  • history of previous RF
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3
Q

Treatment GAS pharyngitis

AND eradicate remaining streptococci

A

Benzathine penicillin G - < 30kg - 600 000 IU IMI stat
> 30kg - 1,2 mil IU IMI stat
Penicillin V - 50mg/kg/day - 3 doses before meals po 10 days - compliance (4 doses to eradicate)

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4
Q

Secondary prevention - RF prophylaxis

A

Benzathine penicillin G - < 30kg 600 000 IU IMI
> 30kg 1,2 mil IU IMI
every 3-4 weeks
Penicillin VK 250mg bd PO

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5
Q

Medical Rx CCF

A

Decrease preload = Diuretics - HCTZ, Furosemide, Spironolactone
Increase contractility and function = Inotropes - Digoxin
IV inotropes - Dopamine, Dobutamine
Decrease the after load = Vasodilators - ACE inhibitors
Control compensatory mechanisms = B blockers - CI in children

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6
Q

Histology

A

inflammatory cell infiltration and proliferation of plump macrophages - anitschkow cells resulting in formation of Aschoff bodies

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