Inflammatory Heart Disease In Pediatric Patients (Msq Drill 86)

1. Is the polyarthritis of rheumatic fever found in the same joints every time or it is migratory?

Found in the same joints everytime

Migratory

2.
Fever, arthralgia and an elevated ESR?CRP are minor components of the Jones criteria for rheumatic fever. What is the effect of rheumatic fever on the PR interval?

Prolonged

Shortened

3. Kawasaki disease is basically a vasculitis of known or unknown origin?

Known

Unknown

4. Kawasaki disease is more prevalent in older or younger kids?

Older kids

Younger kids

peak incidence is 2-3 years

Explanation

peak incidence is 2-3 years

5. Clothes and sheets can elicit pain in the patient with polyarthritis due to rheumatic fever. In addition the joints are red, warm and swollen. True or false?

True

False

6. Carditis can be treated with steroids for inflammation. True or false?

True, in addition salicilates can be used for arthritis

False, actually the steroid will also treat the arthritis

7. Kawasaki disease is most common in what country?

China

Japan

Nigeria

Liberia

Brazil

It is more common in those of asian decent.

Explanation

It is more common in those of asian decent.

8. Basically the convalescent phase of Kawasaki disease begins with the dissappearance of symptoms and continue until the ERS is normal. True or false?

True

False

9. What is the causative agent for rheumatic fever?

Strep viridans

Staph aureus

Staph epididymis

Group A streptococcus

10. Can valves becone stenotic due to rheumatic fever?

Yes

No

11. Sydenham chorea is associated with rheumatoid arthritis. It is associated with clumsiness, worsening handwriting and emotional lability. Is it an early or late manifestation of rheumatic fever?

Early manifestation

Late manifestation

up to several months

Explanation

up to several months

12. Long acting bicillin, oral penicillin, erythromycin and sulfamethoxazole can be used to prevent colonization or infection in those patients that have a history of rheumatic fever. True or false?

True

False

13. The vasculitis of kawasaki disease is characterized by multisystems involvement and inflammation of small to medium sized arteries. What is the end result of this inflammation?

Arterial dissections

Arterial aneurysms

Microvascular blockages

14. Intravenous immuneglobulin (VIG) is used to treat Kawasaki disease. Is the mechanism known or unknown?

Known

Unknown

15. The epidemiology of rheumatic fever mirrors that of strep throat. True or false?

True

False

16. Subcutaneous nodules are manifestations of rheumatic fever. They occur on the extensor surfaces of joints, usually knees and elbows and sometimes the spine. They are uncommon, pea sized and nontender. True or false?

True

False

17. Is scarlet fever also caused by Group A strep?

Yes, this is why a history of scarlet feveris pertinent when working up the patient with rheumatic fever

No, scarlet fever is not caused by group A strep therefore there is no visible link between the two conditions.

18. In which phase of Kawasaki disease will the following occur:

high fever
conjuctivits
mucosal changes such as dry cracked lips and strawberry tongue
cervical lymphadenopathy
swollen hands and feet
variable rash

Acute phase

Subacute phase

Convalescent phase

19. Repeat echocardiograms should be done in patients with Kawasaki disease. True or false?

True

False

20. What is the number one risk factor for rheumatic fever?

5-15 years old

Crowded living conditions

Season of the year

Group A strep pharyngitis

21. What are the three phases of Kawasaki disease?

Prodromal phase

Subacute phase

Convalescent phase

Acute phase

Submit

22. Diagnosis of Kawasaki is made if fever has been present for _____ or more days.

2

3

4

5

6

23. Children with Kawasaki disease can be given aspirin until they are afebrile in addition to an antithrombotic. True or false?

True

False

24. What part of the EKG is affected by rheumatic fever?

P wave

PR interval

QRS interval

ST segment

T wave

rheumatic fever prolongs the PR interval

Explanation

rheumatic fever prolongs the PR interval

25. The patient who presents with rheumatic fever has polyarthritis. Is this form of arthritis symmetric?

Yes

No

26. The erythema marginatum of rheumatic fever is unique. True or false?

True

False

27. Which of the following are are two antibiotics used to treat rheumatic fever?

Oral augmentin for 10 days

Oral penicillin for 10 days

Long acting bactrim DS

Long acting Bicillin IM

Submit

28. What is the specific test that establishes the diagnosis of rheumatic fever?

ASO titer

ANA

There is no specific test

29. The cutaneous manifestation of erythema marginatum is often confused with that of lyme disease. Which of the following is the best dscription of erythema marginatum?

Blotchy with a central clearing

Diffuse with clearly marked borders

Serpiginous (fused) without a central clearing

Serpiginous (fused) with a central clearing

30. Which of the following are the major criteria for diagnosing rheumatic fever according to the Jones criteria?

Polyarthritis

Fever

Carditis

Sydenham's chorea

Cubcutaneous nodules

fever is part of the minor criteria, the other pajor criteria is erythema marginatum

Explanation

fever is part of the minor criteria, the other pajor criteria is erythema marginatum

Submit

31. Which of the following are exceptions to the rule in the diagnosis of rheumatic fever?

Isolated chorea without other cause

Carditis without other etiology

History of rheumatic fever with 1 major or 1 minor cirteria plus evidence of strep infection

Submit

32. Even the general prognosis of Kawasaki disease is good with IVIG and ASA, what complication of Kawasaki disease can lead to sudden death?

Aortic aneurysm

Coronary artery aneurysm

Desquamation

33. Which surfaces of joints, usually knees and elbows usually exhibit the subcutaneous nodules associated with rheumatic fever?

Flexor surfaces

Extensor surfaces

34. In order to establish a group A streptococcus which of the following tests may be considered? Check all that apply.

Throat culture

ASO titer

Streptozyme

Submit

35. What is the ONLY manifestation of rheumatic fever that results in chronic changes?

Vulvular insufficiency

Pancarditis

Scarring

36. Are the subcutaneous nodules associated with rheumatic fever common or uncommon?

Common

Uncommon

37. Which of the following are two drugs that can be given to ameliorate the symtpoms of chorea in the patient with rheumatic fever?

Diazepam

Ziprasidone

Haloperidol

Prozac

Submit

38. Erythema marginatum caused by rheumatic fever is a frequent finding or an infrequent finding?

Frequent finding

Infrequent finding

39. What phase of Kawasaki disease is described below?

Lasts until appr 4th week
gradual resolution of symptoms
desquamation of fingers and toes
thrombosytosis
coronary artery aneurysms

Acute phase

Subacute phase

Convalescent phase

40. Which parts of the body are spared by the polyarthritis of rheumatic fever? Check all that apply.

Fingers

Toes

Spine

Neck

Sacrum

Submit

41. If a patient is diagnosed with Group A strep pharyngitis and undergoes a 10 day treatmetn with oral penicillin. What are the chances that they will develop rheumatic fever?

0%

5%

15%

30%

treatment must begin up to one week after onset of symptoms.

Explanation

treatment must begin up to one week after onset of symptoms.

42. A strawberry tongue is associated with which of the following? Check all that apply.

Kawasaki disease

Scarlet fever

Toxic shock syndrome

Submit

43. 4 out of 5 criteria must be present in order for the diagnosis of kawasaki disease to be made. Which of the following are the four criteria?

Bilateral nonexudative conjuctival injection

Changes inthe lips, tongueor oral mucosa (injection, drying, fissuring red strawberry tongue)

Changes in ESR and CRP count

Changes in the peripheral extremities (edema, erythema and desquamation)

Submit

INFLammatory Heart Disease In Pediatric Patients (Msq Drill 86)

1. Is the polyarthritis of rheumatic fever found in the same joints every time or it is migratory?

2.

What first name or nickname would you like us to use?

2. Fever, arthralgia and an elevated ESR?CRP are minor components of the Jones criteria for rheumatic fever. What is the effect of rheumatic fever on the PR interval?

3. Kawasaki disease is basically a vasculitis of known or unknown origin?

4. Kawasaki disease is more prevalent in older or younger kids?

5. Clothes and sheets can elicit pain in the patient with polyarthritis due to rheumatic fever. In addition the joints are red, warm and swollen. True or false?

6. Carditis can be treated with steroids for inflammation. True or false?

7. Kawasaki disease is most common in what country?

8. Basically the convalescent phase of Kawasaki disease begins with the dissappearance of symptoms and continue until the ERS is normal. True or false?

9. What is the causative agent for rheumatic fever?

10. Can valves becone stenotic due to rheumatic fever?

11. Sydenham chorea is associated with rheumatoid arthritis. It is associated with clumsiness, worsening handwriting and emotional lability. Is it an early or late manifestation of rheumatic fever?

12. Long acting bicillin, oral penicillin, erythromycin and sulfamethoxazole can be used to prevent colonization or infection in those patients that have a history of rheumatic fever. True or false?

13. The vasculitis of kawasaki disease is characterized by multisystems involvement and inflammation of small to medium sized arteries. What is the end result of this inflammation?

14. Intravenous immuneglobulin (VIG) is used to treat Kawasaki disease. Is the mechanism known or unknown?

15. The epidemiology of rheumatic fever mirrors that of strep throat. True or false?

16. Subcutaneous nodules are manifestations of rheumatic fever. They occur on the extensor surfaces of joints, usually knees and elbows and sometimes the spine. They are uncommon, pea sized and nontender. True or false?

17. Is scarlet fever also caused by Group A strep?

18. In which phase of Kawasaki disease will the following occur:high feverconjuctivitsmucosal changes such as dry cracked lips and strawberry tonguecervical lymphadenopathyswollen hands and feetvariable rash

19. Repeat echocardiograms should be done in patients with Kawasaki disease. True or false?

20. What is the number one risk factor for rheumatic fever?

21. What are the three phases of Kawasaki disease?

22. Diagnosis of Kawasaki is made if fever has been present for _____ or more days.

23. Children with Kawasaki disease can be given aspirin until they are afebrile in addition to an antithrombotic. True or false?

24. What part of the EKG is affected by rheumatic fever?

25. The patient who presents with rheumatic fever has polyarthritis. Is this form of arthritis symmetric?

26. The erythema marginatum of rheumatic fever is unique. True or false?

27. Which of the following are are two antibiotics used to treat rheumatic fever?

28. What is the specific test that establishes the diagnosis of rheumatic fever?

29. The cutaneous manifestation of erythema marginatum is often confused with that of lyme disease. Which of the following is the best dscription of erythema marginatum?

30. Which of the following are the major criteria for diagnosing rheumatic fever according to the Jones criteria?

31. Which of the following are exceptions to the rule in the diagnosis of rheumatic fever?

32. Even the general prognosis of Kawasaki disease is good with IVIG and ASA, what complication of Kawasaki disease can lead to sudden death?

33. Which surfaces of joints, usually knees and elbows usually exhibit the subcutaneous nodules associated with rheumatic fever?

34. In order to establish a group A streptococcus which of the following tests may be considered? Check all that apply.

35. What is the ONLY manifestation of rheumatic fever that results in chronic changes?

36. Are the subcutaneous nodules associated with rheumatic fever common or uncommon?

37. Which of the following are two drugs that can be given to ameliorate the symtpoms of chorea in the patient with rheumatic fever?

38. Erythema marginatum caused by rheumatic fever is a frequent finding or an infrequent finding?

39. What phase of Kawasaki disease is described below?Lasts until appr 4th weekgradual resolution of symptomsdesquamation of fingers and toesthrombosytosiscoronary artery aneurysms

40. Which parts of the body are spared by the polyarthritis of rheumatic fever? Check all that apply.

41. If a patient is diagnosed with Group A strep pharyngitis and undergoes a 10 day treatmetn with oral penicillin. What are the chances that they will develop rheumatic fever?

42. A strawberry tongue is associated with which of the following? Check all that apply.

43. 4 out of 5 criteria must be present in order for the diagnosis of kawasaki disease to be made. Which of the following are the four criteria?

2.
Fever, arthralgia and an elevated ESR?CRP are minor components of the Jones criteria for rheumatic fever. What is the effect of rheumatic fever on the PR interval?

18. In which phase of Kawasaki disease will the following occur:

high fever
conjuctivits
mucosal changes such as dry cracked lips and strawberry tongue
cervical lymphadenopathy
swollen hands and feet
variable rash

39. What phase of Kawasaki disease is described below?

Lasts until appr 4th week
gradual resolution of symptoms
desquamation of fingers and toes
thrombosytosis
coronary artery aneurysms