February 1, 2016 - Rheumatic Fever Flashcards
Acute Rheumatic Fever
Is an inflammatory disease that can involve the heart, joints, skin, and brain.
The disease typically develops two to four weeks after a throat infection.
Signs and symptoms include fever, multiple painful joints, and rash.
Acute Strep Pharyngitis
Tonsils are often inflamed and have exudate.
Pathophysiology of Rheumatic Fever
Antibodies which the immune system generates against the highly antigenic M protein may cross-react with cardiac myofibers.
Epidemiology of Rheumatic Fever
Mainly seen in developing countries.
Almost eliminated in North America.
Jones Criteria
Used to help diagnose rheumatic fever. You need at least 2 major criteria and one minor criteria to diagnose as rheumatic fever.
MAJOR CRITERIA —– Polyarthritis, carditis, subcutaneous nodules, erythema marginatum, or Sydenham’s chorea.
MINOR CRITERIA —– Fever, arthralgia, raised ESR or CRP, leukocytosis, ECG showing features of heart block, or a previous episode of rheumatic fever.
Sydenham’s Chorea
Is a disorder characterized by rapid, uncoordinated jerking movements affecting the face, hands and feet.
Occurs in 20-30% of patients with acute rheumatic fever.
Erythema Marginatum
Is a type of erythema involving pink rings on the torso and inner surfaces of the limbs which come and go.
Occurs in about 5% of patients with rheumatic fever.
Right-Sided Valve Involvement
Can be affected, however far less commonly.
This is because it is a low pressure system with fewer Eddy Currents for antibodies or bacteria to be deposited along the valves.
Rheumatic Fever and the Mitral Valve
Leaflet thickening
Shortened chordae tendinae
Commissural fusion
Calcification
Restricted leaflet motion
Rheumatic Fever and the Aortic Valve
♦ Will never occur without mitral valve involvement ♦
Leaflet thickening
Commissural fusion
Calcification
Restricted leaflet motion
Treatment for Group A Strep
Penicillin G
Penicillin V
Amoxicillin
