An inflammatory autoimmune disease that affects the connective tissue of the heart and joint is?

HPSSSB Staff Nurse - 2016

Medical & Surgical Nursing

Easy

Appeared in: HPSSSB Staff Nurse - 2016

Explanation

Rheumatic fever is a systemic, post-streptococcal, non-suppurative inflammatory disease that principally affects the heart and joints.
It is an autoimmune reaction that occurs 2-3 weeks after a group A streptococcal pharyngitis.
The immune response, through a mechanism called molecular mimicry, cross-reacts with self-antigens in the connective tissue of the heart, joints, and other tissues.
The classic presentation involves carditis (inflammation of the heart) and migratory polyarthritis (inflammation of large joints), which directly matches the question's description.
Diagnosis is often made using the Jones criteria, which list carditis and polyarthritis as two of the five major criteria.

Option B: Rheumatoid arthritis is an autoimmune disease, but it primarily causes chronic inflammation of the synovial membranes in joints. While it can have extra-articular manifestations, including in the heart, its defining feature is synovial inflammation, not the combined carditis and arthritis seen in rheumatic fever.
Option C: Osteoarthritis is a degenerative joint disease caused by the mechanical breakdown of cartilage. It is not an autoimmune or systemic inflammatory condition.
Option D: Osteochondritis is a localized inflammation of bone and cartilage, often seen in children and adolescents and related to growth or injury. It is not a systemic autoimmune disease that affects the heart.

Clinical Relevance

Nursing practice connection: Knowing Pathophysiology of Rheumatic Fever helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A key nursing role is patient education on the importance of completing the full course of antibiotics for streptococcal pharyngitis to prevent rheumatic fever.
Nurses must monitor patients for signs of carditis, such as new heart murmurs, tachycardia, chest pain, or signs of heart failure.
For patients with a history of rheumatic fever, adherence to long-term antibiotic prophylaxis is critical to prevent recurrent attacks and progressive rheumatic heart disease.

How to Approach the Question

First, break down the question into its key components: 1) inflammatory, 2) autoimmune, 3) affects connective tissue, 4) involves both the heart and joints.
Evaluate each option against these four criteria.
Eliminate Osteoarthritis because it is degenerative, not autoimmune.
Eliminate Osteochondritis because it is a localized condition, not a systemic autoimmune disease.
Differentiate between Rheumatic fever and Rheumatoid arthritis. While both are autoimmune and affect joints, Rheumatic fever is classically defined by its combined acute impact on both the heart (carditis) and joints (polyarthritis) as a post-infectious syndrome.
Select Rheumatic fever as it is the only option that fits all parts of the description perfectly.

Concept Tested & Keywords

Concept Tested: Pathophysiology of Rheumatic Fever
Stem keywords: inflammatory, autoimmune disease, connective tissue, heart, joint
Lead-in keywords: is

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