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Rheumatic Fever Flashcards

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1
Q

multisystem inflammatory disease resulting from an autoimmune reaction to infection with group A Streptococcus

A

Acute rheumatic fever (ARF)

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2
Q

Many parts of the body may be affected, The major exception is cardiac valvular damage (rheumatic heart disease [RHD])

A

all of the manifestations resolve completely except cardiac valvular damage which may persist after the other features have disappeared

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3
Q

usually presents with fever, anorexia, lethargy and joint pain, 2–3 weeks
after an episode of streptococcal pharyngitis

A

Acute rheumatic fever

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4
Q

usually affects children and young adults between the ages of 5 and 15 years

A

Acute rheumatic fever

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5
Q

remains endemic in the Indian subcontinent, Africa and South America

A

Acute rheumatic fever

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6
Q

have antigens that cross-react with cardiac myosin and sarcolemmal membrane proteins

A

Streptococci

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7
Q

Antibodies produced against the streptococcal antigens cause inflammation in the endocardium, myocardium and as well as the joints, skin and Brain

A

Cause of rheumatic fever

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8
Q

Rheumatic fever causes a

A

pancarditis

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9
Q

pancarditis involving

A

endocardium, myocardium and pericardium to varying degrees

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10
Q

Poverty

A

A risk factors for rheumatic fever

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11
Q

Overcrowding

A

A risk factors for rheumatic fever

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12
Q

limited access to medical care

A

A risk factors for rheumatic fever

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13
Q

Rheumatic fever and resulting endocarditis can cause damage to

A

heart valves

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14
Q

heart valves damage caused by Rheumatic fever and endocarditis are …….. (4)

A

Mitral or Tricuspid regurgitation
Mitral valve prolapse
Aortic regurgitation
Mitral stenosis

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15
Q

Rh. fever Signs and Symptoms Result from …….. in ……

A

inflammation

the heart, joints, skin or
central nervous system

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16
Q

Fever,anorexia or fatigue

A

Rh. Fever symptom

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17
Q

Arthralgia (joint pain)

A

Rh. fever symptom

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18
Q

Arthritis[seenin75%patients]

A

Rh. fever symptom

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19
Q

Carditis

A

Rh. fever symptom

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20
Q

CNS manifestation

A

Rh. fever symptom

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21
Q

Skin manifestation

A

Rh. fever symptom

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22
Q

There may not be any history of sore throat.

A

Rh. fever

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23
Q

Painful and tender joints

A

Arthritis

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24
Q

Arthritis Most often in

A

ankles, knees, wrists, elbows, hip or
shoulders [in order of frequency]

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25
Pain in one joint that migrates to another joint.
Migratory poly arthritis
26
The process of migration lasts for ………
3-6 weeks
27
Red, hot or swollen joints but not deforming
Arthritis
28
Arthritis in Rh. Fever do not progress to
chronic arthritis
29
involves the endocardium (including valves), myocardium and pericardium to varying degrees.
Carditis (pancarditis)
30
Breathlessness, Chest pain and Palpitation
Symptoms of Carditis (pancarditis)
31
Patient may look ill, tired or dyspneic
Cardiac signs of acute Rh. Fever
32
Tachycardia or irregular pulse
Cardiac signs of acute Rh. Fever
33
New murmur or Change in old cardiac murmur
Cardiac signs of acute Rh. Fever
34
soft systolic murmur is very common due to mitral regurgitation
Cardiac signs of acute Rh. Fever
35
Tricusp valve (TV) and Pulmonary valve (PV) are rarely involved in
Cardiac signs of acute Rh. Fever
36
Precordial tenderness
Cardiac signs of acute Rh. Fever
37
Pericardial friction rub
Cardiac signs of acute Rh. Fever
38
Heart failure is …. Due to ….
Cardiac signs of acute Rh. Fever myocarditis or valves dysfunction.
39
Raised JVP ,legs edema, 3rd Heart sound and gallop rhythm
Symptoms of Heart failure
40
one-quarter of affected patients will develop
chronic rheumatic valvular heart disease
41
Which side of the heart usually affected
left side of the heart (Mitral valve and aortic valve)
42
left side of the heart is affected (Mitral valve and aortic valve) called as …..
Rheumatic Heart Disease
43
Subcutaneous nodules
Skin manifestation of Rh fever
44
Small (0.5-2cm),painless nodules under the skin
Subcutaneous nodules
45
Seen in 7% of patients
Subcutaneous nodules
46
It’s present on the extensor surface of bone and tendons
Subcutaneous nodules
47
Subcutaneous nodules typically appear ….
more than 3 weeks after others signs
48
Erythema marginatum
Skin lesion may appear in Rh fever
49
Seen in less than 5%
Erythema marginatum
50
Flat or slightly raised, painless rash
Erythema marginatum
51
Seen mainly on the trunk and proximal extremities but not on the face
Erythema marginatum
52
Sydenham chorea (St. Vitus dance)
CNS manifestation
53
purposeless, involuntary , repetitive, jerky and rapid, movements of the hands, feet or face
Sydenham chorea(St. Vitus dance)
54
late neurological manifestation that appears at least 3 months after the episode of acute rheumatic fever, when all the other signs may have disappeared
Sydenham chorea(St. Vitus dance)
55
occurs in up to one-third of cases and is more common in females
Sydenham chorea(St. Vitus dance)
56
Carditis
Major manifestation
57
Poly arthritis
Major manifestation
58
Chorea
Major manifestation
59
Erythema marginatum
Major manifestation
60
Subcutaneous nodules
Major manifestation
61
Fever
Minor manifestation
62
Arthralgia
Minor manifestation
63
Raised erythrocyte sedimentation rate / C-reactive protein
Minor manifestation
64
Previous rheumatic fever
Minor manifestation
65
Leukocytosis
Minor manifestation
66
1st-degree atrioventricular block
Minor manifestation
67
To diagnose rheumatic fever
Must be evidence of recent strep infection plus 2 major criteria, or 1 major + 2 minor
68
Leucocytosis
Evidence of a systemic illness
69
Raised erythrocyte sedimentation rate
Evidence of a systemic illness
70
C-reactive protein
Evidence of a systemic illness
71
Throat swab culture group A beta-hemolytic streptococci
Evidence preceding streptococcal infection
72
Antistreptolysin O antibioties (ASO titres) Rising titres, or levels of > 200 U for adults or > 300 U for children
Evidence preceding streptococcal infection
73
Chest X-ray To detect …..
Evidence of carditis Cardiomegaly , pulmonary congestion
74
ECG To detect………
Evidence of carditis 1st-degree atrioventricular block 2nd-degree atrioventricular block (rarely) Features of pericarditis T wave inversion Reduction inQRS voltage
75
Echocardiography
Evidence of carditis Cardiac dilatation Vale abnormalities
76
aims of management are
to limit cardiac damage and relieve symptoms.
77
Bed rest Bed
Management of Rh fever
78
Treatment of cardiac failure [If any]
79
Antibiotic therapy: Benzathine benzylpenicillin
Management of Rh fever
80
Aspirin
Management of Rh fever relieves the symptoms of arthritis
81
Steroids [Prednisolone]
Management of Rh fever Rapid symptomatic relief than aspirin
82
indicated in cases with carditis or severe arthritis.
Steroids [Prednisolone]

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