Acute Rheumatic Fever | MDS entrance preaparations

which Of the following is true, regarding Acute Rheumatic Fever? 

A. Invariably associated with mitral valve. 

B. Earliest symptom is patnrut migratory arthritis.
C. Sydenham Chorea is us ually present.
D. It follows streptococcal skin infection.

Ans. (B) 

For Option (A)- Carditis- This is a 'pancarditis' that involves the myocardium and pericardium to varying degrees; its incidence decreases \Nith increasing age, ranging from 90% at 3 years to around 30% in adolescence.

For Option (B)- Arthritis .. This is usually an early feature that tends to occur when streptococcal antibody titres are high. It is the most common major manifestation and is characterized by acute, painful, asymmetric and migratory inflammation of the large joints (typically the knee, ankles, elbows and wrist),   

For Option (B), (D)-Cldnical Features- ARF is a multisystem disorder that typically follows an 

episode of streptococcal pharyngJi'tis characteristically occurs 2-3 weeks after the initial attack of pharyngitis but the patient may give no history of sore throat. Arthritis occurs in approximately 76% of the patients.

For Option (C)- Syde nham's Chorea (St Vitus dance) It occur up to one-third of cases and common in females