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405910
Rheumatic fever
Description
Mind Map on Rheumatic fever, created by priyasai20 on 01/12/2013.
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Mind Map by
priyasai20
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Created by
priyasai20
over 10 years ago
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Resource summary
Rheumatic fever
Streptococcal infection of URT
M antigens react with T cell and stimulate B cell to produce auto antibodies
Recurrent infection of Heart muscles
Myocardium - aschoff noduels ~ fibrinoid degenration + lymphocytes & Plasma cells ;
Tachycardia, s3 & s4, CHF
Endocardium - valvulitis, damaged chordae tendinae, regurgitations - MaTP
Mid diastolic murmur (carey coombs),
valve thickening, scarring, calcification and stenosis
Pansystolic murmur
Pericardium - effusion; bread and butter appearance
pain, friction rub
other Manifestations
Joints
Large Joint inflammation
Migratory
Syndenham's Chorea
characteristic movements of limbs, head and tongue
Manifests late and relsoves in 6 weeks
Subcutaneous nodules
In severe carditis; Over bony prominences
resolves in 2 weeks
Erythema marginatum
Pink rashes: Clear centre and serpiginous margins
Investigations
Blood
ESR
CRP
Antistreptolysin O, Anti DNAse B
Throoat Swab Culture
Chest X-ray
ECG
REVISED JONES CRITERIA 2 Major/ 1 Major+2 minor / 5 minors
Major
Carditis
Polyarthirtis
Major criteria: 2 or more jts, high stretocococcal antibody titre
Chorea
Erythema marginatum
Subcutaneous nodules
Minor
Fever
Arthralgia
Prev RHD
CRP and ESR raised
ECG: Prolonged PR
Treatment
Bed rest
Antibiotics
Benzathine penicillin 1.2m units
Procaine penicillin 6L units
Sensitive cases - Erythromycin 20- 40mg/kg
Arthritis
Aspirin 60mg-8g
CHF
Prednisolone
Chorea
Calm environment, Valproic acid, Immunoglobulins
Prophylaxis:
Secondary
1.2m units Benzathine penicillin, Oral penicillin 500mg, Amoxycillin 1g/day, azithromycin 500mg/day
No carditis
For 5 yr or till 18yr age
resolved carditis
For 10yr or till 25yrs age
severe carditis
Life long prophylaxis; surgery
Primary
Benzathine penicillin, procaine penicillin, Erythromycin
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