Phys Vivas · cardiovascular
Rheumatic Fever AND Rheumatic Heart Disease — Viva Defence
DCE viva defence for Rheumatic Fever AND Rheumatic Heart Disease.
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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]
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