Question

summarize the rationale in your own words

Rationale: A diagnosis of RF is confirmed by the presence of two major manifestations or one major and two minor manifestations from the Jones criteria. In addition, evidence of a recent streptococcal infection is confirmed by positive antistreptolysin O titer, Streptozyme slide tests, or anti-DNase B assays. An antistreptolysin O titer is not a specific laboratory test for the conditions identified in options 1, 3, and 4 Strategy Incorrect Evolret s a registered trademark of Inc in the Uinned State e here to search

Answer 1

*Rheumatic Fever (RF) is an acute, immunologically mediated, multisystem inflammatory disease that occurs a few weeks after infection with certain Group A beta-hemolytic streptococci.

*It occurs mostly in the 5-15 year age group but can occur as young as 18 months and as old as 30 years.

*Certain susceptible individuals possibly with a specific HLA II antigen are prone to rheumatic fever as sequelae to infection with Group A beta-hemolytic streptococci.

*The streptococci contain components (M-proteins) that are antigenically cross-reactive with human tissue. When the immune system mounts a response to a throat infection, the antibodies produced can be cross-reactive with the sarcolemma of cardiac myosites.glycoproteins on endocardium or cytoplasmic proteins in basal ganglia.

*Some of the acute and chronic complications of Rheumatic fever includes:

#Acute: Congestive cardiac failure, Arrhythmias, Mitral valve prolapse, pericarditis

#Chronic: Rheumatic heart disease particularly mitral valve disease and predisposition of Infective Endocarditis.

Acute Rheumatic fever diagnosis can be made by Modified Duckett-Jones Criteria as :

#Evidence of streptococcal infection + 2 major criteria

(or)

#Evidence of streptococcal infection + 1 Major criterion + 2 Minor criteria.

*The 5 Major criteria include:

i)Carditis (Pericarditis, Endocarditis, Myocarditis, Pancarditis)

II)Arthritis (Asymmetrical,non-erosive, migratory polyarthritis)

iii)Chorea/Syndenham's Chorea/St.Vincent's Dance associated with emotional lability.

iv)Subcutaneous Nodules (Pea-sized, painless lumps that are freely mobile and found on extensor surfaces. It can be look over bony surfaces such as knuckles, wrists, spine, elbows)

v) Erythema Marginatum (Transient, migrating,non-pruritic rash on trunk and proximal limbs, leaves circular patterns on trunk and limbs)

*The 6 Minor criteria include:

i) Fever (>38⁰C)

ii) Leucocytosis

iii)Elevated ESR/CRP

iv)Arthralgia (not if arthritis is Major criterion)

v)Prolonged QT interval/First-degree heart block

vi) Previous rheumatic fever

*The count of streptococcal infection can be evidenced by:

i)Positive throat culture

ii)Rapid streptococcal antigen test

iii)Elevated/Rising titers of Anti-streptococcal antibodies

-Anti-Streptolysin O

-Anti-DNAase B

-Anti-streptozyme