Knowledge Check: Acute Rheumatic Fever
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Question 1 of 10
1. Question
Which of the following locations is the most common site of primary group A streptococcal infection that is associated with future development of acute rheumatic fever?
Hint
Acute Rheumatic Fever can affect the heart, joints, CNS and the skin. However, the initial GAS infection is typically a tonsillopharyngitis.
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Question 2 of 10
2. Question
Which age groups of patients are most susceptible to group A streptococcal infections?
Hint
Group A streptococcal tonsillopharyngitis most commonly affects young children and adolescents.
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Question 3 of 10
3. Question
Which of the following contributes to the development of rheumatic heart disease? (Check All that Apply)
Hint
Rheumatic Heart Disease occurs as a result of chronic heart valve damage, from repeated episodes of acute rheumatic fever, which are triggered by repeated untreated Group A Streptococcal infections.
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Question 4 of 10
4. Question
Which of the following heart valves is most commonly affected in rheumatic heart disease?
Hint
Rheumatic heart disease most commonly affects the valve located between the left atrium and left ventricle.
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Question 5 of 10
5. Question
Which of the following items from the Jones criteria is a “minor manifestation” used for diagnosing acute rheumatic fever?
Hint
The “major manifestations” of Jones Criteria are arthritis, carditis, subcutaneous nodules, erythema marginatum and Syndeham’s chorea. The “minor manifestations” are fever, arthralgia, prolonged PR interval on EKG, increased CRP and increased ESR.
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Question 6 of 10
6. Question
Which of the following combinations of signs and symptoms satisfies the Jones Criteria for diagnosis of a first episode of acute rheumatic fever? (Check All that Apply)
Hint
To satisfy the Jones Criteria, one must have 2 major criteria and evidence of GAS infection, or 1 major and 2 minor criteria and evidence of GAS infection.
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Question 7 of 10
7. Question
Which of the following laboratory or imaging results would confirm the diagnosis of acute rheumatic fever in a patient with signs and symptoms concerning for the disease?
Hint
Evidence of previous group A streptococcal infection is required to confirm the diagnosis of acute rheumatic fever.
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Question 8 of 10
8. Question
A 6-year old boy is diagnosed with acute rheumatic Fever. Which of the following is the BEST among first-line treatment option?
Hint
Antibiotics such as penicillin (or erythromycin in case of penicillin allergy) are the preferred treatment for acute rheumatic fever with single IM/IV dose superior to oral treatment.
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Question 9 of 10
9. Question
Which of the following is indicated in the long-term management of acute rheumatic fever?
Hint
Each episode of acute rheumatic fever can further create damage to heart valves.
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Question 10 of 10
10. Question
What is the BEST first-line treatment option for secondary prophylaxis for acute rheumatic fever?
Hint
Injectable Penicillin has been shown to be the best treatment option for secondary prophylaxis. Erythromycin can be given instead of penicillin as a twice daily oral therapy.