Podcast
Questions and Answers
What is the most serious complication associated with rheumatic fever?
What is the most serious complication associated with rheumatic fever?
Which of the following populations has a higher incidence of rheumatic fever?
Which of the following populations has a higher incidence of rheumatic fever?
What environmental factors significantly contribute to the risk of developing rheumatic fever?
What environmental factors significantly contribute to the risk of developing rheumatic fever?
Which statement accurately reflects the demographics of rheumatic fever?
Which statement accurately reflects the demographics of rheumatic fever?
Signup and view all the answers
Which of the following is the sole cause of rheumatic fever?
Which of the following is the sole cause of rheumatic fever?
Signup and view all the answers
What is the estimated prevalence of rheumatic heart disease globally?
What is the estimated prevalence of rheumatic heart disease globally?
Signup and view all the answers
In which circumstances is rheumatic fever least likely to occur?
In which circumstances is rheumatic fever least likely to occur?
Signup and view all the answers
How does genetic predisposition relate to rheumatic fever?
How does genetic predisposition relate to rheumatic fever?
Signup and view all the answers
What is the first sign that a patient has developed valvular disease?
What is the first sign that a patient has developed valvular disease?
Signup and view all the answers
Which of the following symptoms is considered a major criterion for rheumatic fever?
Which of the following symptoms is considered a major criterion for rheumatic fever?
Signup and view all the answers
What is a common finding during a physical examination for diagnosing rheumatic heart disease?
What is a common finding during a physical examination for diagnosing rheumatic heart disease?
Signup and view all the answers
Which option describes a treatment that improves joint symptoms but does not prevent heart injury?
Which option describes a treatment that improves joint symptoms but does not prevent heart injury?
Signup and view all the answers
What percentage of patients experiencing symptoms of rheumatic fever typically have persistence beyond 6 months?
What percentage of patients experiencing symptoms of rheumatic fever typically have persistence beyond 6 months?
Signup and view all the answers
Which laboratory finding indicates an inflammatory reaction in rheumatic fever?
Which laboratory finding indicates an inflammatory reaction in rheumatic fever?
Signup and view all the answers
In patients with rheumatic fever, which of the following is a major manifestation that may be observed?
In patients with rheumatic fever, which of the following is a major manifestation that may be observed?
Signup and view all the answers
What complication is associated with a poor prognosis in patients who develop cardiomegaly from rheumatic heart disease?
What complication is associated with a poor prognosis in patients who develop cardiomegaly from rheumatic heart disease?
Signup and view all the answers
What is commonly found surrounding Aschoff bodies in the cardiac tissue affected by rheumatic fever?
What is commonly found surrounding Aschoff bodies in the cardiac tissue affected by rheumatic fever?
Signup and view all the answers
Which valve is most frequently affected by rheumatic fever-related cardiac complications?
Which valve is most frequently affected by rheumatic fever-related cardiac complications?
Signup and view all the answers
What occurs to the valve leaflets during the acute phase of rheumatic fever?
What occurs to the valve leaflets during the acute phase of rheumatic fever?
Signup and view all the answers
Which clinical manifestation is NOT typically associated with pharyngitis due to group A streptococcus?
Which clinical manifestation is NOT typically associated with pharyngitis due to group A streptococcus?
Signup and view all the answers
What is the consequence of fibrosis that occurs after the acute phase of rheumatic fever in heart valves?
What is the consequence of fibrosis that occurs after the acute phase of rheumatic fever in heart valves?
Signup and view all the answers
In which percentage of rheumatic fever patients does tricuspid valve involvement occur alongside mitral or aortic disease?
In which percentage of rheumatic fever patients does tricuspid valve involvement occur alongside mitral or aortic disease?
Signup and view all the answers
What is the typical time frame within which symptoms of pharyngitis appear after exposure to the infectious agent?
What is the typical time frame within which symptoms of pharyngitis appear after exposure to the infectious agent?
Signup and view all the answers
What laboratory test is most indicative of a group A streptococcus infection in suspected pharyngitis?
What laboratory test is most indicative of a group A streptococcus infection in suspected pharyngitis?
Signup and view all the answers
What is a potential consequence of untreated rheumatic heart disease (RHD)?
What is a potential consequence of untreated rheumatic heart disease (RHD)?
Signup and view all the answers
Why is prophylactic antibiotic treatment essential for patients with RHD?
Why is prophylactic antibiotic treatment essential for patients with RHD?
Signup and view all the answers
What role do anticoagulation efforts play in the management of mitral valve disease?
What role do anticoagulation efforts play in the management of mitral valve disease?
Signup and view all the answers
What is a common treatment approach for patients with symptomatic RHD?
What is a common treatment approach for patients with symptomatic RHD?
Signup and view all the answers
What is the effect of repeated attacks of rheumatic fever on heart valves?
What is the effect of repeated attacks of rheumatic fever on heart valves?
Signup and view all the answers
What preventive measure should be taken before dental or surgical procedures for patients with RHD?
What preventive measure should be taken before dental or surgical procedures for patients with RHD?
Signup and view all the answers
How does rheumatic heart disease affect the heart's structure over time?
How does rheumatic heart disease affect the heart's structure over time?
Signup and view all the answers
What is considered a critical aspect of managing recurrent rheumatic fever in patients?
What is considered a critical aspect of managing recurrent rheumatic fever in patients?
Signup and view all the answers
What is the primary limitation of newer antigen tests for Group A streptococcal infections?
What is the primary limitation of newer antigen tests for Group A streptococcal infections?
Signup and view all the answers
According to the Jones' criteria, how can rheumatic fever be diagnosed after a streptococcal infection?
According to the Jones' criteria, how can rheumatic fever be diagnosed after a streptococcal infection?
Signup and view all the answers
Which of the following is not considered a major manifestation of rheumatic fever?
Which of the following is not considered a major manifestation of rheumatic fever?
Signup and view all the answers
What is the most sensitive test for diagnosing Group A streptococcus?
What is the most sensitive test for diagnosing Group A streptococcus?
Signup and view all the answers
What is a key characteristic of Sydenham chorea in rheumatic fever?
What is a key characteristic of Sydenham chorea in rheumatic fever?
Signup and view all the answers
Which minor criteria can indicate rheumatic fever when present with major manifestations?
Which minor criteria can indicate rheumatic fever when present with major manifestations?
Signup and view all the answers
What is the significance of the 1–5 week period following streptococcal infection in rheumatic fever diagnosis?
What is the significance of the 1–5 week period following streptococcal infection in rheumatic fever diagnosis?
Signup and view all the answers
Why might a negative antigen test for streptococcal infection require confirmation via throat culture?
Why might a negative antigen test for streptococcal infection require confirmation via throat culture?
Signup and view all the answers
Study Notes
Rheumatic Fever (RF) Overview
- RF is an acute, immune-mediated, multisystem inflammatory disease often following an untreated group A β-hemolytic streptococcal throat infection.
- Targets for inflammation include the heart, joints, skin, and central nervous system.
- Most serious complication is valvulitis, leading to rheumatic heart disease (RHD).
- Rare before age 4 and after age 40; significant health issues in underdeveloped regions due to poverty and poor healthcare.
- Approximately 15-20 million people globally have RHD.
- Incidence of RF is higher among Native Hawaiians and Maoris; socioeconomic factors may influence disease prevalence, as race does not significantly impact incidence.
Causes and Risk Factors
- Only one identifiable cause: exposure to group A β-hemolytic streptococci.
- Streptococcal skin infections do not lead to RF.
- Environmental factors such as poverty, overcrowding, and poor hygiene increase risk.
- Family history suggests a genetic predisposition to RF.
Pathophysiology
- RF may exhibit characteristics of an autoimmune disorder.
- Antibodies produced against streptococcus can mistakenly target host tissues, leading to damage, particularly in cardiac cells.
- Presence of Aschoff bodies, localized lesions associated with RF, contributes to tissue injury.
- Mitral valve is involved in up to 60% of cases; damage to heart valves may result in deformities and chronic dysfunction.
- Acute RF phase involves valve swelling, which can later lead to scar tissue formation and functional impairment.
Diagnosis
- Symptoms of pharyngitis appear 1-5 days post-streptococcal infection: sore throat, fever, and difficulty swallowing.
- Physical exam may reveal red pharynx, swollen tonsils, and lymphadenopathy; throat cultures confirm infection.
- Diagnosis requires Jones criteria: at least two major manifestations or one major plus two minor criteria post-infection.
- Major manifestations include carditis, erythema marginatum, subcutaneous nodules, Sydenham chorea, and arthritis.
- Minor signs encompass fever, polyarthralgia, ECG changes, and elevated ESR.
- Sydenham chorea is a rare but definitive sign characterized by involuntary movements.
Prognosis and Complications
- Approximately 2% recurrence rate for RF; serious symptoms like cardiomegaly and heart failure lead to poorer prognosis.
- Symptoms rarely persist beyond six months; identification of valvular disease often follows heart murmur detection.
Treatment and Management
- Bed rest is essential until normal temperature and stable ESR rates are achieved.
- Salicylates (e.g., aspirin) alleviate fever and joint pain but do not alter disease course.
- Oral prednisone may be used for joint symptoms if salicylates are ineffective.
- Patients with RHD require prophylactic antibiotics to prevent endocarditis during dental and surgical procedures.
- Monitoring for cardiac arrhythmias related to mitral valve disease is crucial to initiate anticoagulation when needed.
- Surgical interventions might be necessary for symptomatic RHD patients, emphasizing the importance of preventing recurrent RF episodes with antibiotics.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Explore the essential aspects of Rheumatic Fever, an acute inflammatory disease often triggered by untreated throat infections. This quiz covers symptoms, complications like rheumatic heart disease, and various risk factors, including environmental and genetic predispositions. Understand the global impact and demographics most affected by this condition.
