Pediatrics 02: Rheumatic Fever

Front 1

RF is a complication of ___itis caused by ___

Back 1

pharyngitis
GAS

Front 2

symptoms of RF appear ___ after pharyngitis

Back 2

2-3 weeks

Front 3

whereas GN can be caused by GAS infection of ___, RF can only be caused by GAS infection of ___

Back 3

skin (impetigo)
pharynx

Front 4

RF is caused by an immunologic ___ reaction

Back 4

cross

Front 5

RF is a type ___ hypersensitivity

Back 5

2

Front 6

RF main age range

Back 6

5-15 years old

Front 7

4 manifestations of RF

Back 7

arthritis
carditis
chorea
rash

Front 8

arthritis in RF is ___
___ joints are typically affected first

Back 8

migratory
leg

Front 9

arthritis is more severe in ___ than ___

Back 9

teenagers
children

Front 10

xray of RF arthritis shows
synovial fluid in FR arthritis shows

Back 10

nothing
nothing (sterile)

Front 11

___ (#) joints are typically affected in RF
a joint is typically arthritic for ___ days

Back 11

6--12
<7

Front 12

___ is typically the first manifestation of ARF

Back 12

arthritis

Front 13

2 chest complaints in RF

Back 13

mild/moderate chest discomfort
pleuritic pain

Front 14

main cardiac finding on physical exam in RF

Back 14

new mitral regurgitation

Front 15

RF CXR finding

Back 15

cardiomegaly

Front 16

RF EKG finding

Back 16

AV block (any degree)

Front 17

serology study for carditis

Back 17

antimyosin

Front 18

least common manifestation of RF

Back 18

subcutaneous nodules

Front 19

subcutaneous nodules in RF are ___ (2)

Back 19

firm
painless

Front 20

subcutaneous nodules in RF are located near ___ (2)

Back 20

tendon
bony prominence

Front 21

erythema marginatum looks like ___

Back 21

ringworm

Front 22

erythema marginatum typically affects ___

Back 22

trunk
proximal limbs

Front 23

erythema marginatum occurs early/late in RF

Back 23

early

Front 24

Jones criteria for RF

Back 24

recent GAS pharyngitis +
2 major criteria
or
recent GAS pharyngitis +
1 major +
2 minor

Front 25

5 major Jones RF criteria

Back 25

Subcutaneous nodules
Pancarditis
Arthritis
Chorea
Erythema marginatum

Front 26

4 minor Jones RF criteria

Back 26

fever
arthralgia
ESR or CRP high
prolonged PR interval

Front 27

erythema marginatum is pruritic/non

Back 27

non

Front 28

prior GAS infection may be ascertained by measuring ___

Back 28

anti-strep Abs

Front 29

main anti-strep Ab is ___
3 others are ___

Back 29

anti-streptolysin
anti-DNAse
anti-streptokinase
anti-hyaluronidase

Front 30

migratory arthritis of RF must be distinguished from ___

Back 30

post-strep reactive arthritis

Front 31

PSRA differs from RF migratory arthritis in ___ (4)

Back 31

later onset
worse response to NSAIDs
usually no carditis
associated with GN and tenosynovitis

Front 32

first 2 steps in RF tx

Back 32

bed rest
monitor for carditis

Front 33

acute antibiotic tx for RF: ___ or ___ for ___ days
dose is ___

Back 33

penicillin PO
erythromycin PO
10
40 mg/kg/day

Front 34

penicillin PO may be replaced by ___

Back 34

IM benzathine penicillin

Front 35

chronic antibiotic tx for RF is ___ for ___ years or until ___
if carditis is present, tx is for ___ years

Back 35

IM benzathine penicillin
5 years
21 years old
10 years

Front 36

patients with carditis + residual heart disease receive antibiotics for ___ years

Back 36

lifelong

Front 37

tx for arthritis is ___
dose is ___

Back 37

ASA
100 mg/kg/day

Front 38

tx for carditis is ___
dose is ___

Back 38

prednisone
2 mg/kg/day

Front 39

tx for chorea is ___
dose is ___

Back 39

phenobarbital
16-32 mg/8 hours

Front 40

___ is a manifestation implying high risk of heart disease
therefore people with this get ___

Back 40

chorea
long-term prophylaxis

Front 41

3 GAS pharyngitis sx
main age range is ___

Back 41

tender anterior cervical lymphadenopathy
erythematous, exudative tonsils
fever>38C
age 3--14

Front 42

if 1 symptom is present, do ___
if more is present, do ___

Back 42

nothing
culture + ABs if positive

Front 43

GAS is diagnosed by ___ (2)

Back 43

rapid strep test
throat culture

Front 44

7 complications of GAS pharyngitis

Back 44

otitis media
sinusitis
peritonsillar abscess
scarlet fever
RF
GN
invasive disease

Front 45

invasive GAS disease means

Back 45

GAS in blood, CSF or pleural fluid

Front 46

2 parts of tx for invasive GAS disease

Back 46

admit to hospital
antibiotics

Front 47

antibiotic tx for invasive GAS disease (2)

Back 47

clindamycin 40 mg/kg + IV penicillin