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47 Cards in this Set
- Front
- Back
RF is a complication of ___itis caused by ___
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pharyngitis
GAS |
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symptoms of RF appear ___ after pharyngitis
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2-3 weeks
|
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whereas GN can be caused by GAS infection of ___, RF can only be caused by GAS infection of ___
|
skin (impetigo)
pharynx |
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RF is caused by an immunologic ___ reaction
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cross
|
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RF is a type ___ hypersensitivity
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2
|
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RF main age range
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5-15 years old
|
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4 manifestations of RF
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arthritis
carditis chorea rash |
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arthritis in RF is ___
___ joints are typically affected first |
migratory
leg |
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arthritis is more severe in ___ than ___
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teenagers
children |
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xray of RF arthritis shows
synovial fluid in FR arthritis shows |
nothing
nothing (sterile) |
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___ (#) joints are typically affected in RF
a joint is typically arthritic for ___ days |
6--12
<7 |
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___ is typically the first manifestation of ARF
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arthritis
|
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2 chest complaints in RF
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mild/moderate chest discomfort
pleuritic pain |
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main cardiac finding on physical exam in RF
|
new mitral regurgitation
|
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RF CXR finding
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cardiomegaly
|
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RF EKG finding
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AV block (any degree)
|
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serology study for carditis
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antimyosin
|
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least common manifestation of RF
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subcutaneous nodules
|
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subcutaneous nodules in RF are ___ (2)
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firm
painless |
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subcutaneous nodules in RF are located near ___ (2)
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tendon
bony prominence |
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erythema marginatum looks like ___
|
ringworm
|
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erythema marginatum typically affects ___
|
trunk
proximal limbs |
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erythema marginatum occurs early/late in RF
|
early
|
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Jones criteria for RF
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recent GAS pharyngitis +
2 major criteria or recent GAS pharyngitis + 1 major + 2 minor |
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5 major Jones RF criteria
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Subcutaneous nodules
Pancarditis Arthritis Chorea Erythema marginatum |
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4 minor Jones RF criteria
|
fever
arthralgia ESR or CRP high prolonged PR interval |
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erythema marginatum is pruritic/non
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non
|
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prior GAS infection may be ascertained by measuring ___
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anti-strep Abs
|
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main anti-strep Ab is ___
3 others are ___ |
anti-streptolysin
anti-DNAse anti-streptokinase anti-hyaluronidase |
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migratory arthritis of RF must be distinguished from ___
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post-strep reactive arthritis
|
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PSRA differs from RF migratory arthritis in ___ (4)
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later onset
worse response to NSAIDs usually no carditis associated with GN and tenosynovitis |
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first 2 steps in RF tx
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bed rest
monitor for carditis |
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acute antibiotic tx for RF: ___ or ___ for ___ days
dose is ___ |
penicillin PO
erythromycin PO 10 40 mg/kg/day |
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penicillin PO may be replaced by ___
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IM benzathine penicillin
|
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chronic antibiotic tx for RF is ___ for ___ years or until ___
if carditis is present, tx is for ___ years |
IM benzathine penicillin
5 years 21 years old 10 years |
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patients with carditis + residual heart disease receive antibiotics for ___ years
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lifelong
|
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tx for arthritis is ___
dose is ___ |
ASA
100 mg/kg/day |
|
tx for carditis is ___
dose is ___ |
prednisone
2 mg/kg/day |
|
tx for chorea is ___
dose is ___ |
phenobarbital
16-32 mg/8 hours |
|
___ is a manifestation implying high risk of heart disease
therefore people with this get ___ |
chorea
long-term prophylaxis |
|
3 GAS pharyngitis sx
main age range is ___ |
tender anterior cervical lymphadenopathy
erythematous, exudative tonsils fever>38C age 3--14 |
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if 1 symptom is present, do ___
if more is present, do ___ |
nothing
culture + ABs if positive |
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GAS is diagnosed by ___ (2)
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rapid strep test
throat culture |
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7 complications of GAS pharyngitis
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otitis media
sinusitis peritonsillar abscess scarlet fever RF GN invasive disease |
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invasive GAS disease means
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GAS in blood, CSF or pleural fluid
|
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2 parts of tx for invasive GAS disease
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admit to hospital
antibiotics |
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antibiotic tx for invasive GAS disease (2)
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clindamycin 40 mg/kg + IV penicillin
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