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Cardiology Internal Med. > Rheumatic Fever > Flashcards

Rheumatic Fever Flashcards

(51 cards)

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1
Q

Explain rheumatic heart fever?

A

Acute
Inflammatory
Non communicable

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2
Q

What pathology is secondary only to streptococcal throat infection?

A

Rheumatic heart fever

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3
Q

Name a condition which is secondary to both streptococcal skin and throat infection?

A

Post-streptococal glomerulonephritis

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4
Q

Carriers of rheumatic heart fever are at low risk of 3%only.True or False

A

True

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5
Q

Name the criteria used for diagnosis of rheumatic heart fever?

A

Jones criteria

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6
Q

What is the most common age group to develop rheumatic heart fever

A

5-15 years

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7
Q

Jones Diagnostic criteria

A

2 major/ 1 major+2 minor

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8
Q

Name conditions that fall in major jones criteria

A 
Polyarthritis 
Pan carditis 
Erythema marginatum
Subcutaneous nodules 
Sydenhams chorea
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9
Q

What clinical features come under minor jones criteria

A

Polyarthralgia

Fever

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10
Q

What lab results are stated under minor criteria

A

Increased ESR
Increased CRP
Increased ASO titres

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11
Q

What ecg finding is stated under minor jones criteria?

A

Increased PR interval

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12
Q

What is the essential criteria for diagnosis of rheumatic heart fever?

A

Positive throat culture
Recent streptococcal infection
Recent scarlet fever
Positive ASO titres

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13
Q

What drug category is used in polyarthritis?

A

Salicylates

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14
Q

What joints are most commonly affected in polyarthritis?

A 
Large joints WAKE
Wrist
Ankle
Knee
Elbow
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15
Q

Name the most common major symptoms of rheumatic heart fever

A

Polyarthritis

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16
Q

Name the most common major condition that causes death in rheumatic heart fever?

A

Pan carditis

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17
Q

What is the other name for pericarditis?

A

Bread and butter carditis

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18
Q

What are pathognomonic sign of myocarditis in pan carditis?

A

Aschoff bodies

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19
Q

What are the two types of endocarditis seen in pan carditis?

A

Valvular (shows aschoff bodies)

Mural (shows MC calum bodies and Aschoff bodies)

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20
Q

What are the 4 components of Aschoff bodies?

A

Primary T lymphocytes
Anthiscow cells (modified macrophages)
Giant cells
Plasma cells

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21
Q

Which major symptom of rheumatic heart fever never occurs isolated?

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A

Subcutaneous nodules (occurs mostly. With carditis)

22
Q

What are the size of subcutaneous nodules?

23
Q

Subcutaneous nodules in rheumatic heart fever are painless.

True or false

24
Q

Subcutaneous nodules occurs near bony prominences of ?

Study These Flashcards
A 
(VWOKE)
Vertebrae 
Wrist 
Occiput
Knee
Elbow
25
Which is last manifestation to occur in rheumatic heart fever?
Sydenhams chorea
26
Sydenham’s chorea of pregnancy?
Chorea gravidarum
27
Precipitation factors of chorea?
Pregnancy OCPs Recurring streptococcus infection
28
How much time does patient generally take to recover from Sydenham’s chorea
6 months
29
Typical symptoms of chorea?
Milkmaids grip Darting of protruded tongue Pronator sign Spooning of extended hand
30
Name 2 clinical condition in rheumatic heart fever that occur with carditis?
Subcutaneous nodules | Erythema marginatum
31
Erythema marginatum is on the face and is pruritic. True or false
False
32
What is modified jones diagnostics criteria?
1. 2 major/1 major&2minor with increased ASO titres 2. Recurrent rheumatic heart fever without established RHD 3. Recurrent rheumatic heart fever with established RHD 4. Rheumatic chorea 5. valvular lesions (MS/MR/AR)
33
Most common affected valve in rheumatic heart fever?
Mitral valve(MAT P) Aortic>tricuspid >pulmonary
34
Earliest valvular lesion in acute rheumatic fever?
Mitral regurgitation
35
Earliest valvular lesion in chronic rheumatic fever?
Mitral stenosis
36
Drug of choice in patients with polyarthritis,arthralagia,fever?
Aspirin, penicillin
37
What is drug dosage of aspirin in children
50-60 mg/kg/day to 80-100mg/kg/day
38
What is dosage of aspirin in adults?
4-8g/day
39
What is the possible toxicity of aspirin ?
Tinnitus | Nausea, vomiting
40
What drug is used if aspirin is not tolerated by the patient?
NSAID (naproxen)
41
What is dosage of napraxone used if aspirin is not tolerated?
10-20mg/kg/day
42
If patient is refractory to aspirin and nsaids then what can you give?
Corticosteroids (prednisone and prednisolones)
43
Route of administration for benzathine penicillin
IM
44
Dosage of benzathine penicillin?
1.2mn units | If patient <27 kgs then 6 lakh units
45
Oral preparation of penoxymethyl penicillin?
500mg/kg/day | 250mg/kg/day (if <27kg of weight)
46
Patients who are allergic to penicillin are given which antibiotic drug?
Sulfadiazene, sulfisoxazole OR Erythromycin
47
If a patient with carditis lands up in congestive heart failure which drug will you give?
Glucocorticoids (prednisone)
48
In case of moderate to severe rheumatic chorea what drug will you prescribe?
Valproic acid or carbamazepine | Rest in very mild cases
49
Secondary prophylaxis regime in Rheumatic heart fever without carditis?
For 5 years or upto age of 21 years | Whichever is longer
50
Secondary prophylaxis regimen in rheumatic heart fever with carditis but no valvular lesion?
For 10 years or upto age of 21 years | Which ever is longer
51
Secondary prophylaxis regimen for rheumatic heart fever with carditis and residual valvular lesion?
For 10 years or upto age of 40 years | Which ever is longer

Cardiology Internal Med. (10 decks)

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