USMLE Forum Archives - USMLE Step 1 - Pathology 40
Pathology 40
TheOne - 11-26-06 16:45
A 41-year-old patient informs her physician that in her childhood, she experienced two bouts of rheumatic fever. Although she appears to be well at present, which of the following sequelae of rheumatic fever is most likely to present as a chronic disease in her later years?
A. Arthritis
B. Fibrinous pericarditis
C. Mitral valve disease
D. Myocarditis
E. Neurological disease
TheOne - 11-26-06 16:45
A 41-year-old patient informs her physician that in her childhood, she experienced two bouts of rheumatic fever. Although she appears to be well at present, which of the following sequelae of rheumatic fever is most likely to present as a chronic disease in her later years?
A. Arthritis
B. Fibrinous pericarditis
C. Mitral valve disease
D. Myocarditis
E. Neurological disease
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#2
Re: Pathology 40 suresh - 11-28-06 11:45 c.mitral valve is the most frequently involved one in this setting.
#3
Re: Pathology 40
TheOne - 11-30-06 20:20 Explanation: The correct answer is C. After an initial attack of rheumatic fever, an affected individual is at increased risk for developing recurrent rheumatic disease after each pharyngeal infection by beta-hemolytic streptococci. Any one of the manifestations of rheumatic disease can reoccur, but will usually resolve. In marked contrast, the damage to the heart valves caused by rheumatic fever can lead to fibrous scarring and deformity, producing valvular dysfunction (particularly mitral stenosis), which may lead to heart failure in late adulthood. The arthritis (choice A) produced by rheumatic fever is transitory, and resolves after the attack has run its course. There are no long-term complications of the arthritis. Fibrinous pericarditis (choice B), like almost any fibrinous inflammatory response, is an acute process. Although the patient may develop some scarring of the pericardium, this is generally not sufficient to produce long-lasting consequences. Myocardial involvement (choice D) by rheumatic fever is typically seen as Aschoff bodies, collections of fibrinoid necrosis, lymphocytes, plasma cells, and histiocytes within the myocardium. When the event resolves, the Aschoff bodies will be replaced by discrete fibrous scars. No appreciable myocardial dysfunction ensues. Sydenham's chorea, the neurologic manifestation of rheumatic fever, leaves no lasting neurological effects (choice E).
#4
Re: Pathology 40 galaxy - 05-28-10 02:44 A 41-year-old patient informs her physician that in her childhood, she experienced two bouts of rheumatic fever. Although she appears to be well at present, which of the following sequelae of rheumatic fever is most likely to present as a chronic disease in her later years?
C. Mitral valve disease
#5
Re: Pathology 40 babbu5508 - 06-21-10 15:39 C. Mitral valve disease...rheumatic carditis is a longterm complication of rheumatic fever and most likely involves mitral> aortic>tricuspid valves
#6
Re: Pathology 40 bingousmle - 06-30-10 21:49 sequelae of rheumatic fever which is most likely to present as a chronic disease in her later years is surely Mitral valve disease
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