Rhematic Fever Flashcards by Moatasem Salah

Def rhematic fever

Auto immune inflammatory dx involoving 5
Heart
Large joints
Chore
Skin
Skin

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Mention organism causing rehmatic fever all names

Group A B-hemolytic streptoccoci
Streptococcus pyrogens

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What is meant by b hemolytic

Complete hemolysis on the blood agar

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Mention story of incidence

5-15 y in developing countries
Equal both البنات دماغهم طاقه
In developing countries

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Cause of rehmativ fever

Following upper respirate tract infection or scarlet fever or impetigo after 2 to 4 weeks group a better hemolytic streptoccoci
In presence of genetic susceptibility

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What is the antigen of the tissues that is containing molecular mimicry

Myosin

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Describe pathogensis of rhemuatic feverr…

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Once carditid always……..

Carditis

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Mentio the two types of lesion done in rehmatic fever

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Which is more specific in evidence of strepto coccus (scarlet fever or pharyngitid)

Scarlet fever bec it is done only by streptococcus pyobens onlyyyyyuhuyyyyyy

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How to spot imptigo

Honeycomb scles

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How to spot scarlet fever

S sreptococcus
S sand paper rash
S strawberry rash

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What is modification of johns criteria

Subclincal carditits
Poly arthralgia

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Chorea 1st inv

Echo

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How to diagnose rheumatic fever according to criteria

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What is significnace of sc nodules in rh fever

Poor prognosis it indicates fibrosis

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What is modified criteria for diagnosis of rheumatic fever?

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What is a minor criteria for the diagnosis of rheumatic fever?

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How to differentiate between digital toxicity and ECG changes, traumatic fever

By ECG at DC digital ST segment depression curved

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What are the evidence of the strept

يا اما هيا او اللي طلع ضدها او أونبص في الزور او سكارليت

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Diagnosis based on two major criteria is……… based on one major and two minor

Stronger

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Own rhematic fever, manifestations, are reversible except

Carditis

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Define arthralgia

Joint pain only

Define arthritis

Joint pain, red, hot, tender, swollen with limited mobility

Evidence for recent streptoccocs infection is required for all cases except

Chorea

Diagnosis of recurrent fever dependence on

Three minor criteria Two major criteria One major +2 minor criteria Plus evidence of infection

Probable rehmatic fever

One major or one minor or absence of a streptococcal serology

Cp of rhematic fever

Arthritis 70 Pan carditis 50 Chorea 15 Erythema marginatum 5 Sc nodules 2-10

Mention characters of arthritis of rhematic fever

70 % Signs of inflm Polyarthritis Big joints Fleeting Fate no no Salicylates dramatic Asymmetrical

When arthritis is mono at

Early stage

Describe erythema margintum

Red macules with clear pale center Sharp prog margins Recurrent Trunk limbs No itchy No face

Sc nodules describtion`

Small Painless swellimhs Prominences bones Not inflammed

Why sc nodules may ne missed

Skin is notw inflammed

Rheumatic chorea maybe the only manifestation of automatic fever

Because it occurs late after the manifestations after four months, and the echo is essential to exclude subclinical carditis

Progmosis of chroea

Self limite

Decribe manifestions of chorea

Most serious manifestation of rheumatic fever

Pen carditis

GR; what at carey comb murmr appears at mid diastole and pre systole

Due to atrial contraction against stenosis

How to differentiate between the number of joint affected

More than five is poly 2 to 4 is oligo 1 mono

What is the function of pericardium?

Limit the diastole of the heart

Describe becks triad

Pericardial effusion Tender liver Congested neck veins Distant heart sound

What makes distant heart sound

Pericardial effusion

How the pain and the rub disappears during pericarditis

Boy treatment By effusion

All affection of endocardium is regurge except

3 stensis Fibrosis Carey comb Austin flint

Which part of the endocardium is more affected?

Left side mitral valve

Describe Austin flint murur

Aortic regurge Functional mitral stenosis Atrial contractions at diastole Transient s4

Functional mitral stenosis

Austin flint

What makes double Apex and describe it

One Apex at diastole which is abnormal atrial contraction Bikes at all, which is normal ventricle contraction

Soft systolic murmur propagating to axilla muffled S1

Mitral regurge

Soft systolic murmur propagating to Azela with S1

Double mitral lesion

Why weak S1

Loss of muscular component due to myocarditis

Decribe endocarditis

Or austin flint

Describe myocarditis , pericarditis of rheumatic fever

How to differentiate between the pericardial rub and a precordial pain from pelusristy

If the pain is not related to respiration, so it’s cardiac

Mention all galloping of heart during rhematic

Most common s3 indication for chf Transient se for carey comb

According to robotic heart, disease lesions are usually seen in

Adolescence

What are the early complications of rheumatic heart?

Congestive heart failure dilated with S3 Dysrrthmia

Differentiate between other causes of arthritis

Why rhematic arthritis doesn’t damage the joint while rhemotiod damage the joint

Because it damages a articular cartilage while at Eelmatic, it damages, synovial membrane, and synovial fluid

How to differentiate between rheumatic. Chorea and the other causes of chorea

Wilson liver damage CNS affection(tremors, rigidity, gait affection) Increase liver copper content decrease the serum ceruplasmin

Differentiate the innocent murmur from rheumatic murmur

Mention inv done incase case of rhematic fever

Throat swab is usually negative

As organism usually dissaperead from pharynx

Esr may be normal in case of chorea

Due to late affection

Echo use incase of rhematic fever

Valvular insufficient Ventricular dilation

Flask shaped heart

Pericardial effusion

Ecg findings incase of rhematic fever

Prolonged pr

Can rhematic occur after tonsillectomy

Yes by scarlest fever Pharingitis

Is asot positive is enough

No must rising titre 250-400

Max dose of cortisol

60 mg

Primary prevention is hard

Bec 30% of cases are subclinical

Decribe the preventive ttt of rhematic fever

Benzathine penicillin Dose Route Duration Se

Mention specific ttt of rhematic fevevr

Asprini dose for arthritis

100mg/ kg / day for 2-3 weeks 75mg/ kg / 3 times w-3 weeks

Carditis ttt doses

Predensione 2mg/kg/day for 2 weeks then taper over 4 weeks And start 75mg/ kv for 6 weeks

Mention primary prevention doses of penecilin

Rhematic Fever Flashcards

(80 cards)