1. Name the myocardial
lesion. What is the leading theory for the cause of the injury to the
heart? How does this differ from the mechanism thought to be involved
in the glomerulonephritis that can be associated with infection by the same
organism (beta-hemolytic streptococcus)?
2. Does the pericardial
lesion account for the friction rub? What other diseases commonly
cause such a finding?
3. What criteria are used
clinically to make a diagnosis in this kind of case?
4. This child, however,
got well and had no further problems except that he was maintained on
penicillin for many years and heart murmur was noted on routine physicals.
Still to this day, his dentist won't fill a cavity without placing him back
on antibiotics. Why?
5. At age 40 the patient
developed progressive left heart failure. Prior to the 1960s, this patient
probably would have gradually succumbed to this problem. Figure
3 shows what could have been found
at autopsy. Describe what you see.
6. This patient had a valve
prosthesis surgically implanted. Is the patient's risk of infectious
endocarditis definitely reduced at last?
7. Is this a typical
history for this disease? How does one distinguish rheumatic valvular
disease from other chronic causes of valve deformity?
8.
Is this still a common scenario (i.e. new cases
of acute rheumatic fever)?
