NEET MDS

The Power Course

Revised jones criteria which of these not in diagnosis of acute rheumatic fever.



Choices

1 ) One major and two minor criteria
2 ) Two major criteria
3 ) Three minor criteria in the first episode of rheumatic fever
4 ) In subsequent episodes, documentation of group A streptococcal infection is necessary

Explanation


Revised Jones criteria are newer one i.e published in the year 2015, modified Jones was published in the year 1992 check this link

Revised Jones criteria based on population at risk i.e low risk has bit different criteria compared to the moderate and high-risk groups. 

Low-risk populations

Major criteria: carditis (clinical and/or subclinical), arthritis (polyarthritis), chorea, erythema marginatum, and subcutaneous nodules

Minor criteria: polyarthralgia, fever (≥38.5° F), sedimentation rate ≥60 mm and/or C-reactive protein (CRP) ≥3.0 mg/dl, and prolonged PR interval (unless carditis is a major criterion)

Moderate and high-risk populations

Major criteria: carditis (clinical and/or subclinical), arthritis (monopolyarthritis or polyarthritis, or polyarthralgia), chorea, erythema marginatum, and subcutaneous nodules

Minor criteria: fever (≥38.5° F), sedimentation rate ≥30 mm and/or CRP ≥3.0 mg/dl, and prolonged PR interval (unless carditis is a major criterion)

Note:- Monoarthrities in moderate and high-risk population is also considered as major criteria unlike in low-risk population

Diagnosis in the initial episode

Two major criteria or one major two minor criteria

Diagnosis of subsequent episodes

Because recurrent acute rheumatic fever is common in know case of acute rheumatic fever the criteria have been modified for these set individuals

Two Major criteria or one major and two minor criteria or three minor criteria

for all these documentation of group, A streptococcal infection is mandatory.


Answer

Three minor criteria in the first episode of rheumatic fever

Further Reading


Modified Jones criteria of 1992.

Major Criteria

Carditis, Migratory  polyarthritis, Sydenham's Chorea, Subcutaneous nodules and Erythema marginatum

Minor Criteria  

Fever, Arthralgia, Elevated acute phase reactant, Prolonged PR interval in ECG

Essential Criteria

Supporting Evidence of recent group A streptococcal infection

A positive throat culture or rapid antigen detection test and/ or elevated or increasing streptococcal antibody test

To fulfill the Jones criteria. Two major or one major and two minor criteria with essential criteria are needed


Last Modified : 25-Dec-2019

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