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