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Cardiology IPAP > ARF > Flashcards

ARF Flashcards

(61 cards)

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1
Q

What is the main stay of Symptomatic ARF TXT

A

ASA Children 80-100mg/kg/D Adults 4-8g/D

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2
Q

What age do you see RF

A

5-15yo

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3
Q

Is there a specific TXT for ARF rash?

A

No

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4
Q

Antibodies tested for in RF

A
  1. ASO (antistreptolysin O)
  2. Anti-DNase B 3.ASTZ (antistreptozyme)
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5
Q

Prolonged PRI is due to

A

Early carditis

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6
Q

What new murmur may a RF pt develop

A

Transient (MC) MR or AR

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7
Q

What type of Rx prophylaxis is continuously used?

A

PCN G benzathine (IM) PCN V (PO) Sulfadiazine IF allergic

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8
Q

Sydenham’s chorea is

A

Neurologic D/O of abrupt rapid involuntary nonrhythmic movement (Stops when sleeping)

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9
Q

Prophylaxis for RF w/carditis and w/out valvular disease?

A

Prophylaxis for 10 years or until pt is 21yo

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10
Q

When do you DC TXT

A

Until ALL S/S are gone and ESR/CRP are NL

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11
Q

TXT of carditis

A

TXT HF, Heart block, or valve repair or replacement for nonresponsive HF

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12
Q

DX of ARF requires

A 
Strep evidence 
\+
(Jones)
MAJ  2                                                                                
MAJ  1 + 2 Min
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13
Q

Evidence of GAS inf is

A

POS antibodies (elevated/rising) or POS Cx/Rapid test

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14
Q

What is the most severe sequela of ARF

A

Rheumatic heart DZ

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15
Q

Valvular damage from RF is also known as

A

Rheumatic heart disease

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16
Q

MAJ JONES critera includes

A

J - Joints (Migratory polyarthritis)
O - Carditis
N - nodules (SQ)
E - Erythema marginatum
S - Sydenham’s chorea

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17
Q

Dx tests for RF include

A

Strep A Rapid/CX, Antibody titer CRP and ESR
CXR (Cardiomegaly or HF)
EKG (heart blocks)

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18
Q

Carditis presents as

A

Early in Dz New murmur Pancarditis and friction rub Cardiomegaly

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19
Q

Prophylaxis for RF w/carditis and persistent valve disease?

A

Prophylaxis for 10 years or until pt is 40yo Sometimes lifelong

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20
Q

What is secondline med if unresponsive to ASA

A

CCS (prednisone)

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21
Q

Erythema Marginatum

A

Rash that’s non-pruritic/non-painful eruption raised or flat patches on trunk and prox extremities

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22
Q

RF subQ nodules are

A

Firm painless nodules on wrists, elbows, knees and achilles lasting for 1-2 weeks

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23
Q

RF non-specific S/S

A

Fever
Joint aches Abdominal pain
Weakness
Fatigue

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24
Q

Migratory Poly-arthritis is

A

Severe pain in large joints of extremities w/ rubor, calor, tumor, dolor - lasting <4wks

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25
TXT of ARF consists of
ABX, HF management, Anti-inflammatory
26
Pt with RF usually have what hx
Pharyngitis associated with scarlet fever or other sequale
27
RF DX based on (Not Definitive)
Evidence of GAS infection + POS Jones criteria
28
RF - What usually manifests w/ SubQ nodules
Carditis (early RF)
29
If patient has PCN allergy what Rxs to use?
Macrolides (Azithromycin, Clarithromycin, Clindamycin)
30
In what order does heart blocks appear in ARF?
1. Complete heart block 2. 2nd degree heart block 3. 1st degree heart block (Long PRI) 4. Normal Sinus rhythm
31
75% pts w/ RF usually have
Migratory Poly-arthritis
32
Prophylaxis for RF w/out carditis?
Prophylaxis for 5 years until 21yo
33
Which valves are most commonly affected in order
(MC) Mitral Aortic (can be common) Tricuspid (rare)
34
Presumptive RF dx made if (3)
1. Sydenham’s Chorea is only manifestation 2. Indolent carditis (pt fails to get TXT) 3. Recurrent RF w/ ARF with any manifestation
35
What valves can be affected by ARF
Mitral, Aortic, tricuspid
36
What two S/S of ARF resolve the quickest
Polyarthritis and carditis
37
What is a common EKG finding of carditis
Heart block
38
RF specific S/S
Arthritis in joints but evolves one at a time ABNL heart beat Chest Pain Red patches on skin Small painless lumps beneath skin
39
What may be the sole manifestation of ARF in an unTXT pt?
Indolent carditis
40
Is there TXT for RF progressive valvular damage?
No
41
Minor jones criteria
Arthralgias (without arthritis) Fever: 101F to 104F Elevated acute phase reactants (ESR and CRP) Prolonged PR Interval on ECG
42
What is the latent period before ARF S/S after a GAS infection?
f3 Wks
43
What does ARF prevention consist of
Primary -Prompt Dx and ABX of GAS pharyngitis Secondary - GAS Prophylaxis
44
Acute RF is
A delayed, non-suppurative sequelae of a pharyngeal GAS infection
45
When do you switch from IM PCN to PO?
Young adult hood and has remaied free of rheumatic attacks
46
ABX TXT of RF
1st line Penicillin for 10D
47
Can RF occur from GAS skin infection?
No
48
50% of pts with RF have
Carditis (early RF)
49
Another name for sydenham's chorea?
St. Vitus dance
50
Generally what is the time frame of heart block progression
18D
51
Goals of RF treatment
S/S relief Eradicate/Prophylaxis GAS
52
How long can valvular damage set in from RF?
10-30 years
53
What is the least common S/S of RF
SQ nodules
54
What two Major S/S present early in DZ?
Poly-arthritis and Carditis (Resolve quickly too)
55
What major S/S of ARF peaks at 2.5 months?
Nodules (SQ)
56
What does Syndenhams Chorea start? And how long?
Later and longer
57
Can anything slow the progression of valvular damage?
NO
58
What is Primary PVT of ARF?
Prompt DX and TXT
59
What is Secondary PVT of ARF?
Prophylaxis
60
MC new murmur associated with RF
MR 1st then AR
61
What murmur commonly develops w/ RHD?
MS 1st then AS (Rarely TS)

Cardiology IPAP (20 decks)

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