4. Etiology ☆ a nonsuppurative complication of group A streptococcal infection of the upper respiratory tract ☆ occurs 1 - 4 weeks after convalescence of infection ☆ individual propensity ☆ environmental factors latitude altitude humidity nutrition crowding age
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6. capsule （ synovial membranes ） Cell wall protein （ myocardium, endocardium ） Cell wall polysaccharides （ myocardium, endocardium ） cell membrane protein （ myocardium 、 subthalamic nucleus 、 caudate nucleus ） The antigens of Group A streptococci and molecular mimicry
7. pathology 急性渗出期（ acute exudative period ） 增生期（ proliferative period ） 硬化期 (sclerotic period) 1 month 3~4 months 2~3 months connective tissue edemas ,effuse, and degenerate, infiltrated with inflammatory cells. Aschoff body in myocardium, muscle, endocardium, subcutaneous tissue collagen fiber hyperplasia and scar tissue formation mitral >aortic>tricuspid>pulmonary
8. acute exudative period edema and degeneration of collagen and exudation in pericardium pericardial effusion fibrinous pericarditis
9. proliferative period Aschoff body in endocardium 中心： fibrinoid necrosis of collagen 外周： lymphocytes, plasma cells and Aschoff giant cells Aschoff giant cell large cells with two or more pale nuclei that have prominent nucleoli.
10. sclerotic period mitral valve shows thickening distorted cusps, adherent commissures with calcification and thrombus deposition, fusion and shortening of chordae tendinae. stenotic mitral valve shows fusion of commissures, thickening and calcification of the cusps. commissures are fused; cusps are severely thickened. The valve is both incompetent and stenotic.
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22. The Jones Criteria Revised with Addition of World Health Organization Recommendations Major Criteria Minor Criteria Carditis Fever Polyarthritis, migratory Arthralgia Erythema marginatum increased acute-phase reactants Chorea ESR↑, CRP↑ Subcutaneous nodules Prolonged P-R interval Plus Evidence of a preceding group A streptococcal infection (culture, rapid antigen, antibody titers rise/elevation, scarlet fever) ★ two major manifestations + Evidence of S.I (streptococcal infection ) ★ one major ＋ two minor manifestations + Evidence of S.I
50. Aneurysm at left anterior descending ( LAD) coronary artery LAD Coronary Artery Aneurysm — 20~30% of untreated children normal coronary artery
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Notes de l'éditeur
All right , provide some little tips You should remember the word – MY HEART to help to review the clinical features of KD. M ,h,e ------------------may respectly respectively ------------------------------------- The whole word may remind us the abnormalities of coronary arteries and heard.
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