Rheumatic fever

Question 1

What is Rheumatic fever?

Answer 1

1. a condition which develops following recent immunological reaction to Strep Pyogenes infection
2. AKA Group A beta haemolytic strep

Question 2

Name 4 potential signs of a recent Strep pyogenes infection?

Answer 2

1. Positive throat culture
2. Rapid strep Ag test
3. Anti streptolysin O level in the blood ( antibody in response to group A strep)
4. Recent scarlet fever / tonsillitis

Question 3

Name 1 symptoms of joint involvement

Answer 3

Migratory arthritis affecting the large joints, with hot, swollen, painful joints

Question 4

Name 4 symptoms of CVS involvement

Answer 4

Carditis, or inflammation throughout the heart, with pericarditis, myocarditis and endocarditis, leads to:

1. Tachycardia or bradycardia
2. Murmurs from valvular heart disease, typically mitral valve disease
3. Pericardial rub on auscultation
4. Heart failure

Question 5

Name 2 symptoms of skin involvement

Answer 5

1. Subcutaneous nodules - Firm painless nodules occur over extensor surfaces of joints, such as the elbows.
2. erythema marginatum - rash involves pink rings of varying sizes affecting the torso and proximal limbs.

Question 6

Name 1 symptoms of nervous system involvement

Answer 6

1. Sydenham chorea

2. This involves irregular, uncontrolled and rapid movements of the limbs.