Rhumatic fever Flashcards
(22 cards)
is rheumatic fever infectious disease ?
no, its a complication of scalet fever or strut throat infection that caused by not any bacteria but because the strepto bacteria
is strepto bacteria responsible for the complication of the valvular disease ?
no, but the immunological response to the bacteria
because the bacterial antigen cross react with the target organ and AB cross react with the heart and the brain
whats the initial attacks of the disease ?
and the latent period ?
attack the pt from 6 yrs to 20 but rarely oattack at age above 30yrs
and the latent period until the appearance of the syptmoas is 18 days that means from 1 week to 5 week
and acute attack cure after 3months (12weeks)
If pt have rheumatic fever (at the time of presentation )
dose the bacterial culture is beneficial ?
only 25% pf the pt who are diseased the bacterial culture for them is pstitive .
whats the most common feature of rheumatoid fever ?
is a migratory arthritis in 80% pf pt usually with fever and rarely causes deformity
which type of joint dose the rheumatoid fever attack ?
rheumatoid fever attack the large joint 1-shoulder 2- elbow 3-knee 4-ankle but rheumatoid arthritis attack the small joint
How the rheumatic fever affect the heart ?
it's cause pan carditis means involve all the layers of the heart pericarditis new or changing murmur cardiomegaly heart failure
pt who have carditis which type of problem will experience ?
60%will having moral valve then40% develop combined mitral and aortic .
whats the sedenham chorea ?
dancing movement of the hands and the feet at the initial time of presentation .
erythema marginatum لازم نحفظ الصوره
its rare happened in 10%
what the carditis considered in the rheumatoid fever?
its the most lethal signs
شنو هو الفحص المختبري الي يني انو سبب المراض الي بالقلب هو حمى الروماتيديه؟
by Antistreptolysin O (ASO) titer is a blood test to measure antibodies against streptolysin O and anti DNAase or antihyurindase النتيجه هي ٩٠٪
is throat culture beneficial ?
no it only used in the recent infection only
ARE C-reactive and ESR important in diagnosis ?
not important in diagnosis but more use as follow up
COULD U USE THE ECG FOR DIGNOSIS THE CARDITIS ?
YES, ECG IS HELPFUL FOR CARDITIS IF PR ARE PROLONG (normally the PR interval less than one small square is larger its prolong )بس هذا ما يعتبر علامه خطره انو راح يصير بي مرض بالقلب
شلون اشخص انو هذا المرض الي بالقلب سببه الحمى الروماتيديه ؟بدون فحص بالاب ؟
according two criteria
TWO MAJOR OR TWO MINOR + evidence of strept inf
what’re the majo criteria r in the rheumatoid disease ?
major = MSC 1- migratory arthritis 2-sunceoutanous nodule 3-sydenham chorea 4-carditis
what’re the minor criteria ?
fever and arthralgia
elveted reactant and prolong PR
how to treatment ?
1- treat the acute attack
2- treat the current infection
3- treat the further attack
which drug is used ?
pencillin is used as treatment of acute attack while the parenteral benzathine penicillin (1.2 m unit for 4 week )because its have long term action used to prevent further attack واذا البيت مال المريض مزدحم اطي كل ٣ اسابيع
and aspirin as analgesia and we use high doses to work as Anti-inflmtory effect
NSID for treat the sever carditis
NSID should be tapered … reduced 25% each week after 2-3 weeks
steroid as prednisolone should dose reduced taper over 2weeks and instead use high dose of aspirin
methylpredsolone in sever cases
haloperidol is an antipsychotic medicine treat chorea
if pt allergic pt penicillin?
used oral cephalosporin rather than erythromycin .
شكد نظل نطي المريض بروفيلاكسس؟
for 1O yrs as AHA recommended بس الدكتور كال مدى الحياة
