RF

Question 1

Pathogenesis

Answer 1

-Post Strep Infection (esp Pharyngitis) –> Ag gets into circulation –> recognised by B-cells –> HSR

1. Ig cross react with heart (all 3)

2. IC formation (Glom. Nephritis + Vasculitis)

Question 2

Epideomology

Answer 2

-Decreased in Developed Countries

Question 3

Acute RF

Answer 3

1.Heart:

• Pancarditis
• Aschoff Bodies (Granulomatous rxn)
• Endocardium: Fibrinoid necrosis on Closure of Valves –> Vegetations called Veruccae (little effect)
• Fibrinoid Pericarditis

2. Joints:

• Migratory Polyartheritis –> Large Joint
  *At start no joint deformities

3. Skin:

• Subcut Nodules
• Erythema Marginatum

4. CNS:

• Syndenham Chorea (ataxic movement of extremities)

Question 4

Chronic RF

Answer 4

1. Stenosi/Insufficiency (mitral mostly): fibrosis of the verruca on valves
2. Fish Mouth Stensosi
3. Mural Thrombi (Dilation of LA)
4. RVHT

Question 5

Diagnosis

Answer 5

-Serological Evidence of Strep A infection + JONES