Phys Written Answers · cardiovascular
Rheumatic Fever AND Rheumatic Heart Disease — Written Clinical Reasoning
DCE-style written reasoning for Rheumatic Fever AND Rheumatic Heart Disease.
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Target exams
SAQ 1 — Integrated plan (12 marks)
Prompt: Provide a prioritised problem list and management sequence for this presentation. [1] [2]
Model Answer
1. Frame and red flags (3 marks) [1]
State the working diagnosis/syndrome, acuity, and what would force emergency treatment now. [1] [2]
2. Discriminating assessment (3 marks) [2]
List the key history, examination and investigations that separate dangerous differentials from benign mimics. [1] [2]
3. Treatment sequence (4 marks) [1] [3]
Immediate stabilisation, disease-specific therapy, monitoring, and complications prevention. [1] [2] [3]
4. Follow-up and communication (2 marks) [2]
Disposition, safety-net advice, and who owns follow-up. [1] [2]
References3ShowHide
- [1]Gewitz MH, Baltimore RS, Tani LY, et al. Revision of the Jones Criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography Circulation, 2015.PMID 25908771
- [2]Kumar RK, Antunes MJ, Beaton A, et al. Contemporary Diagnosis and Management of Rheumatic Heart Disease: Implications for Closing the Gap Circulation, 2020.PMID 33073615
- [3]Bray JJ, Thompson S, Seitler S, et al. Long-term antibiotic prophylaxis for prevention of rheumatic fever recurrence and progression to rheumatic heart disease Cochrane Database Syst Rev, 2024.PMID 39312290