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Phys Vivascardiovascular

Phys Vivas · cardiovascular

Rheumatic Fever AND Rheumatic Heart Disease — Viva Defence

DCE viva defence for Rheumatic Fever AND Rheumatic Heart Disease.

1 min readVerification in progress

Target exams

FRACP DCEMRCP PACES
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Study tools

Target exams

FRACP DCEMRCP PACES
Prompt
DCE viva defence for Rheumatic Fever AND Rheumatic Heart Disease.

Rheumatic Fever AND Rheumatic Heart Disease Viva

Long Case Viva Defence

Opening statement

"This patient presents with a problem best framed as Rheumatic Fever AND Rheumatic Heart Disease. My priorities are to identify red flags, confirm the mechanism with purposeful investigations, start a sequenced management plan, and integrate multimorbidity and follow-up." [1] [2]

Examiner questions

Q1: "What makes this urgent?" [1]

"I look for threats to airway, perfusion, neurology, metabolism, infection or bleeding, and I escalate those before elective work-up." [1] [2]

Q2: "What is your first investigation package?" [2]

"I order tests that change management now, not a scattergun panel." [1] [2]

Q3: "Walk me through treatment." [1]

"Stabilise, treat the mechanism, prevent complications, and plan monitoring." [1] [2] [3]

Q4: "What is the classic trap?" [2]

"Treating a label without confirming the discriminating mechanism, or delaying escalation." [1] [2]

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References3ShowHide
  1. [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. [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. [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
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