Notes for Student Nurses

Introduction: Acute Rheumatic fever: Acute Rheumatic Fever (ARF) is an acute autoimmune disease that occurs as a sequel  of group A- streptococcal infection which is characterized by inflammation of connective tissue, primarily affecting the joints and heart. Rheumatic Heart Disease is a condition that occurs when rheumatic fever causes long term damage to the heart and its valves. Etiology: Most initial attack of ARF occur 1 to 5 weeks (average 3 weeks) after a streptococcal throat infection or infections of the upper respiratory tract. Peak incidence among children between ages 6 to 15.  A family history of Rheumatic fever and lower economic status are additional factors. Pathophysiology: Clinical Manifestations: Major Manifestations: (JONES Criteria) Carditis : Manifested by systolic or diastolic murmur, prolonged PR and QT interval on ECG, and possibly by signs of CHF in echo. Poly-arthritis: Pain and limited movement of two or more joints. Joints are swollen, red, warm, and tend

Systemic Lupus Erythematous (SLE) is a chronic, multisystem, inflammatory, autoimmune disorder characterised by formation of autoantibodies directed against self-antigens and immune-complex formation resulting in damage to essentially any organ. Clinical Manifestations : Assessment and Diagnostic Findings : Diagnosis of lupus is difficult because sign and symptoms vary considerably from person to person. Signs and symptoms lupus may vary over time and overlap with those of many other disorders. No one test can diagnose lupus. The combination of blood and urine tests, sign and symptoms and physical examination findings leads to the diagnosis .  Laboratory and imaging tests include : 1. Complete Blood count  2. Erythrocyte sedimentation rate  3. Kidney and liver assessment 4. Antinuclear antibody ( ANA ) test 5. Chest X-ray  6. Echocardiogram 7. Urinalysis The American College of Rheumatology has established criteria for the classificatio