Rheumatic Fever

Question 1

Rheumatic fever develops after which condition?

Answer 1

Streptococcal pharyngitis

Question 2

Strep throat is more likely to lead to rheumatic fever in which group?

Answer 2

Children

Question 3

What is the most common clinical sign in patients with (acute) rheumatic fever?

Answer 3

1. Migratory polyarthritis - multiple large joints inflammation
2. Pancarditis - inflammation of all 3 layers of the cardium

Question 4

What is the most common cause of death in rheumatic fever?

Answer 4

Myocarditis caused by rheumatic fever

Myocarditis can cause heart failure

Question 5

In endocarditis caused by rheumatic fever, which valves are most affected?

Answer 5

Mitral valve most likely, but aortic can also be affected

Question 6

What signs on the arms or face may be present in someone with (Acute) rheumatic fever?

Answer 6

1. Subcutaneous nodules
2. Erythema marginatum
3. Sydenham chorea (rapid movements of face and arms) - appears later on in the disease

Question 7

Ultimately what are the 5 diagnostic signs that indicate rheumatic fever

Answer 7

Polyarthritis
Carditis
Subcutaneous nodules
Erythema marginatum
Sydenham chorea

(also blood test showing previous strep infection)

Question 8

How is acute rheumatic fever treated?

Answer 8

Usually resolves with rest + anti inflammatory medication + antibiotics

Question 9

In chronic rheumatic heart disease, which valves undergo fibrous scarring?

Answer 9

Mitral valve and sometimes aortic valve

Fibrous scarring can cause mitral stenosis and regurgitation