Summer.Thunder
Forum Elite
Topics: 71
Posts: 180
|
A 12-year-old girl is admitted to the hospital
because of marked shortness of breath, an
erythematous rash, and painful, swollen hip and
knee joints. She is agitated. A chest x-ray shows
an enlarged heart and changes consistent with
pulmonary edema. Intractable congestive heart
failure develops, and she dies on the second
hospital day. This child most likely had a recent
history of which of the following?
answer is pharyngitis,
can someone explain this to me? thanks
|
| hottie99
Forum Guru
Topics: 32
Posts: 608
|
the child has rheumatic fever rite based on the symptoms, so what causes that?? strep group A, as that is the most common cause of pharyngitis
to get more about it, check out answers.com (i never used wikipedia, and i find this site more reliable to check up a lot of things)
http://www.answers.com/rheumatic+fever?cat=health
does that sound good to u?
Edited by hottie99 on 03/31/08 - 08:01 PM
|
| spinal shock
Forum Senior
Topics: 12
Posts: 99
|
well i say its rheumatic fever secondory to bacterial pharyngitis, bac Ags cross react with self Ag causing acute endocarditis which is due to rheumatoid arthritis.
___________________
we expect others wishes, we dont miss something that we dont expect to have
|
| shumaila
Forum Elite
Topics: 58
Posts: 347
|
could it be kawasaki?
|
| hottie99
Forum Guru
Topics: 32
Posts: 608
|
i dont think it's kawasaki bc that doesnt have arthritis (like the pt above has hip/knee arthritis) and if they did have kawasaki's, that is really high fever (greater than 103 for AT LEAST 5 days) as a requirement and they have rash on palms/soles rite? so this patient doesnt have that.. also kawasaki another name is mucocutaneous lymph node syndrome, so there would be involvement of oral mucosa and skin for sure, this patient has arthritis and heart problems which can be from strep throat infection causing rheumatic fever.
|
| macintosh
Forum Elite
Topics: 38
Posts: 178
|
The signs are characteristic of rheumatic myocarditis, and GAS (aka step. pyogenes) may be the most likely preceeding cause. Carditis may involve the heart muscle (inflammation-antischkow), pericardium (pericarditis), and the valves (MR, MS - I do not remember which is more common of the two). Valvular regurgitation and systolic dysfunction may lead to an enlarged heart and pulmonary congestion.
I have just one question. Could the enlarged heart may actually mean dilated/congestive cardiomyopathy. If so, is rheumatic carditis a cause of dilated cardiomyopathy?
|
|
| |
| | | | | | |
