True about Rheumatic fever
Answer is A (Chorea is aggrevated during pregnancy) Sydenham's chorea may be aggravated by pregnancy. 'Patient's with sydenham's chorea may have chorea during pregnancy (chorea gravidarum) and are at higher risk of chorea induced by phenytoin or oral contraceptives' - The 5- Minute Neurology consult (2003) /399 Sydenhom's chorea usually occurs in isolation and is not associated with ahritis usually. Subcutaneous nodules are typically non tender. Rheumatic fever is associated with Erythema marginatum and not Erythema multiforme Featues of Sydenham's chorea in Rheumatic Fever (10-15% of patients) It usually occurs after a prolonged latent period after group A streptococcus It usually occurs in the absence of other manifestation (usually not associated with ahritis or carditis) It usually occurs in females Presents as rapid, jerkey, involuntary movements (choreiform movements) affecting predominantly the Head /Face and Upper limbs May be generalized or restricted to one side / asymmetrical Typical signs include Milk maid Grip Spooning of extended hands Daing of the protruded tongue Pronator signs Typically associated with excessive emotional lability and personality changes It is a self limiting condition and eventually resolves completely, usually within 6 weeks. Recurrence of chorea may be seen late after complete resolution Factors inducing Recurrence Pregnancy (Chorea gravidorum) Re infection with streptocossus / non specific infections Use of oral contraceptives
Chorea is aggravated during pregnancy
Chorea & ahritis co-existing
Subcutaneous nodules are tender
Erythema multiforme seen