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13 Cards in this Set
- Front
- Back
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What is RF caused by?
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Streptococcal pyogenes - gram positive cocci
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What is required before RF?
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Prior tonsillitis/pharyngitis infection 3-4wks earlier
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What are the symptoms of tonsillitis?
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Red and/or swollen tonsils with yellow patches, sore throat, fever, headache, malaise, nausea
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Why does the immune system attack cardiac myofibre, collagen and connective tissue?
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Surface protein from s.pyogenes is similar to cardiac myofibre, collagen and connective tissue called 'molecular mimic'. Results in antibody cross reactivity. An anti-body mediated immune response caused by type 2 hypersensitivity reaction. Heart too big to engulf, macrophages release damaging toxins
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How do you diagnose RF?
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Jones' Criteria. Two major or 1 major and 2 minor plus evidence of recent S.pyogenes infection
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What are the Major Criteria in Jones' criteria?
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Joints (migatory arthritis), carditis, subcutaneous nodules, erythema marginatum (rash), Sydenham's Chorea (St Vitus dance)
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What are the minor criteria in Jones' criteria?
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Fever, raised C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) and prolonged pulse rate
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How do you determine if recent S.pyogenes infection?
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Streptozyme - blood test screening for antibodies against a range of streptococcal antigens
Throat swab, gram-stain, streptococcal serology |
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What is the treatment of RF?
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Reduce inflammation (NSAIDs, corticosteroids), eradicate S.pyogenes (oral penicillin 10 days), continuous low dose oral or IM injection antibiotics for years
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What is bacterial endocarditis caused by?
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S.aureus, Viridans streptococci, entercoccus, pseudomans aeruginsa
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What are the risk factors for BE?
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reduced blood flow around valves, poor dental hygiene, dental work, abnormal endothelial surface of heart valves (ease of attachment)
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How do you diagnose BE?
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ECHO evidence of vegetation(>1cm), evidence of emboli (lesions on hands), bacteremia, positive culture for typical organisms
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What is the treatment of BE?
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high dose IV antibiotics for 4-6 weeks. Repair or removal or damaged heart valve. Oral antibiotics when getting dental work done
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