Rheumatic Heart Disease Flashcards
How do you treat strep throat in penicillin allergy
Erythromycin ethylsuccinate
Orally every 6 hours for ten days (before meals)
Adult 250 mg
What treatment do you give for strep throat in a patient on warfarin
Phenoxymethyl penicillin (pen VK)
Orally every 12 hours for 10 days
250-500mg
Primary prevention of RF
All sore throats in children 3-15 y/o should be treated as strep throat and treated
Benzathine benzylpenicillin
Single IM injection
1.2 million units (50% if under 30 kgs)
What clinical characteristics deter from a diagnosis of strep throat
Ulceration
Hoarseness
Watery nasal secretions
Conjunctivitis
Define primary prevention in RHD
The prevent ion of the first attack of rheumatic fever by vigorous standardized treatment of strep sore throat
Secondary prophylaxis of RF
Benzathine benzylpenicillin
Single IM every 3-4 weeks
1.2 million units
Without carditis - 5 years or until 18 whichever is longer With carditis (mild regurg) - 10 years or until 25 More severe valve disease or valve surgery - lifelong
Common complications of RHD
Heart failure Atrial fibrillation Acute rheumatic fever Stroke Infective endocarditis
Histological finding in ARF
Aschoff nodule
ASAP Programme for control of RHD
Awareness raising
Surveillance
Advocacy
Prevention
Four pillars of RF/RHD control
Education (professional/public)
Treat sore throat syndromically
2ndry prophylaxis in register based programme
Surveillance through notification
Major Jones criteria
Carditis Arthritis (migrating, effecting larger joints) Subcutaneous nodules Erythema marginatum Sydenham's chorea
Minor jones criteria
Fever Raised ESR or CRP Arthralgia Prolonged PR interval Previous RF
Pathogenesis of RF
Genetic susceptibility (~3% of people) Environmental factors (NB overcrowding, poverty) Infection with a group A streptococcus
