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20 Cards in this Set
- Front
- Back
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Most common cause of acquired heart disease in kids
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Kawasaki syndrome
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Epideomolgy of Kawasaki
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Boys > girls
Asians and black > whites Very common in Japan |
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Kawasaki buzzwords
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Fever that does not get better with anitbiotics
toddler fever >5 days must have 4 of these: conjuctivitis polymorphous rash cervial adenopathy dry/fissured lips or swollen tongue erythema/induration leading to desquamation of hands and feet |
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Kawasaki affects on the heart
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coronary artery aneursyms and stenosis (ectasia)
may lead to MI, sudden death, or ischemic heart disease increased risk in boys and <1 |
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Labs for Kawasaki
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elevated acute phase reactants
elevated ESR elevated platelets elevated WBC count elevated liver transaminases |
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Tx of Kawasaki
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IV gamma globulin
to decrease chance of coronary artery involvement (not eliminate) Asprin high dose till fever is down then low dose for 6-8 weeks until ESR and platelet count is normal |
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Cardiomegaly
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NOT a sign of Kawasaki
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Second most common cause of acquired heart disease in kids
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Rheumatic fever
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Cause of Rheumatic fever
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group a strep infection in THROAT 3 weeks ago
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Increased risk for rheuatic fever
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high family incidence
6-15 low socioeconomic status |
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Jones Criteria major
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subcutaneous nodles
carditis chorea erythema marginatum arthritis |
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Jones Criteria minor
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arthralgia (not inflammation)
fever of 38 C elevated ESR, C-reactive protein Prolonged PR interval |
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What is needed for a Dx of Rheumatic fever?
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Must have evidence of preceeding strep throat
2 major & 1 minor or 1 major & 2 minors |
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Carditis in RF
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occurs 1-2 weeks after strep throat
prior attacks increase risk and increase severity affects mitral valve most also aortic valve |
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Arthritis of RF
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involves large joints:
elbows knee ankle wrists migratory and there is redness, swelling, pain, & tenderness because it is inflammation |
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Sydenham's chorea
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purposeless, choreiform movements
aggravated by stress and emotionally labile |
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Erythema marginitum of RF
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serpiginous
worses with heat (because there is inflammation) not on the face |
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Subcutaneous nodules of RF
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seen more in chronic RF
painless located on extensor surfaces of joints |
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Tx of RF
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supportive care
bed rest treat strep infection anti-inflammatory asprin predisonse reserved for severe cases of carditis |
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RF prophylatics
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to prevent recurrence given penicillin (if not alergic) until 21-25 yrs old or for life if in a high risk group such as teachers, military, or medical field
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