Rheumatic Fever Clinical Manifestations
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Questions and Answers

What is the typical time frame for acute rheumatic fever to occur following group A streptococcal pharyngitis?

  • 2 to 4 years
  • 2 to 4 days
  • 2 to 4 weeks (correct)
  • 2 to 4 months

    • Which of the following is NOT a clinical manifestation that can develop in relation to group A streptococcal pharyngitis?

  • Chorea
  • Pneumonia (correct)
  • Carditis
  • Subcutaneous nodules

    • What is the long-term consequence of rheumatic fever on the heart and its valves?

  • Chronic progressive damage to the heart and its valves (correct)
  • No impact on the heart and its valves
  • Rapid healing and recovery of the heart valves
  • Temporary inflammation of the heart

    • What were the Jones criteria formulated for in 1944?

    <p>To assist in the identification of rheumatic fever</p> Signup and view all the answers

    What is thought to be the primary reason for the decline in the incidence of rheumatic fever?

    <p>Introduction of antibiotics</p> Signup and view all the answers

    At what age does acute rheumatic fever typically occur?

    <p>School-aged years</p> Signup and view all the answers

    Which medication may compete with penicillin G for renal tubular secretion, potentially increasing penicillin serum concentrations?

    <p>Ethacrynic acid</p> Signup and view all the answers

    What is a potential fetal risk associated with the use of glucocorticoids?

    <p>Osteonecrosis</p> Signup and view all the answers

    Which condition is a contraindication for the use of neuroleptic agents?

    <p>Severe hypotension</p> Signup and view all the answers

    What is a contraindication for the use of aspirin?

    <p>Vitamin K deficiency</p> Signup and view all the answers

    What is the recommended approach for the primary prevention of acute rheumatic fever (ARF)?

    <p>Eradication of Streptococcus from the pharynx</p> Signup and view all the answers

    What is the duration of secondary prevention for individuals with ARF and carditis but no residual valve disease?

    <p>10 years or until 21 years of age</p> Signup and view all the answers

    What complications are dependent upon the severity of carditis during an acute attack of ARF?

    <p>Mitral stenosis and regurgitation</p> Signup and view all the answers

    What surgical intervention should be considered in patients with active carditis, especially those with cases refractory to medical care or requiring high doses of vasodilators and diuretics?

    <p>Valve replacement</p> Signup and view all the answers

    Which medication may compete with penicillin G for renal tubular secretion, potentially increasing penicillin serum concentrations?

    <p>Ethacrynic acid</p> Signup and view all the answers

    What is a potential fetal risk associated with the use of glucocorticoids?

    <p>Osteonecrosis</p> Signup and view all the answers

    Which condition is a contraindication for the use of neuroleptic agents?

    <p>Severe hypotension</p> Signup and view all the answers

    What is a contraindication for the use of aspirin?

    <p>Vitamin K deficiency</p> Signup and view all the answers

    What is the recommended approach for the primary prevention of acute rheumatic fever (ARF)?

    <p>Eradication of Streptococcus from the pharynx</p> Signup and view all the answers

    What is the major cause of long-term morbidity in acute rheumatic fever?

    <p>Valvular vegetations (endocarditis)</p> Signup and view all the answers

    What is the most commonly acquired heart disease in hospitalized children, adolescents, and young adults in less developed nations?

    <p>Rheumatic heart disease</p> Signup and view all the answers

    What is the estimated percentage of patients with acute rheumatic fever that will develop rheumatic heart disease worldwide?

    <p>60%</p> Signup and view all the answers

    What is the cause of left ventricular dilation and congestive heart failure in acute rheumatic fever?

    <p>Valvular vegetations (endocarditis)</p> Signup and view all the answers

    What is thought to play a role in the pathogenic mechanisms that cause acute rheumatic fever?

    <p>Genetic susceptibility</p> Signup and view all the answers

    Which factor has a direct proportional relationship with morbidity from acute rheumatic fever?

    <p>Rate of streptococcal infections</p> Signup and view all the answers

    What is the primary cause of death and disability in children and adolescents in developing nations and lower socioeconomic areas?

    <p>Acute rheumatic fever</p> Signup and view all the answers

    Which age group has the highest reported cases of individuals affected by acute rheumatic fever?

    <p>5-15 years</p> Signup and view all the answers

    What is the characteristic complaint for patients with rheumatic fever?

    <p>Overt arthritis with warmth, swelling, redness, and exquisite tenderness</p> Signup and view all the answers

    What is the primary diagnostic method used for acute rheumatic fever?

    <p>Positive throat culture for streptococcus group A antigen</p> Signup and view all the answers

    What is associated with an inverse relationship with the risk of developing carditis in acute rheumatic fever?

    <p>Severity of joint involvement</p> Signup and view all the answers

    Which of the following is a major criterion for the diagnosis of acute rheumatic fever?

    <p>Presence of subcutaneous nodules (Aschoff bodies)</p> Signup and view all the answers

    What is the most frequent cause of mitral stenosis?

    <p>Rheumatic fever</p> Signup and view all the answers

    What is the gold standard for the diagnosis of rheumatic heart disease?

    <p>Echocardiography with Doppler</p> Signup and view all the answers

    What is the recommended treatment for acute rheumatic fever without carditis?

    <p>Aspirin</p> Signup and view all the answers

    Which laboratory test should be performed to disclose preceding streptococcal infection in acute rheumatic fever?

    <p>Throat culture to isolate group A streptococci</p> Signup and view all the answers

    What is the characteristic movement disorder that occurs in a percentage of acute rheumatic fever cases?

    <p>&quot;St Vitus dance&quot;</p> Signup and view all the answers

    Which of the following is a treatment strategy for the management of acute rheumatic fever?

    <p>Intravenous immunoglobulin (IVIG)</p> Signup and view all the answers

    What should be performed in all cases of confirmed and suspected acute rheumatic fever to assess whether carditis is present?

    <p>Echocardiography with Doppler</p> Signup and view all the answers

    What is the most appropriate antimicrobial treatment for the eradication of streptococcal infection in acute rheumatic fever?

    <p>Penicillin G</p> Signup and view all the answers

    What is a possible symptom that may indicate severe polyarthritis in acute rheumatic fever?

    <p>Persistent joint pain at rest</p> Signup and view all the answers

    In what proportion of cases does erythema marginatum, a characteristic rash, occur in acute rheumatic fever patients?

    <p>Approximately 5%</p> Signup and view all the answers

    What is the typical onset for Sydenham chorea, a characteristic movement disorder in acute rheumatic fever?

    <p>Several months after other symptoms</p> Signup and view all the answers

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