Question:medium
In rheumatic fever, steroids are indicated when there is which of the following?
In rheumatic fever, steroids are indicated when there is which of the following?
Show Hint
Steroids are reserved for the manifestation that threatens the heart.
Updated On: Jun 24, 2026
- Carditis
- Chorea
- Subcutaneous nodules
- All of the above
Show Solution
The Correct Option is A
Solution and Explanation
Step 1: The decision to use steroids versus aspirin in rheumatic fever rests almost entirely on the presence and severity of cardiac inflammation.
Step 2: Carditis, particularly when accompanied by heart failure, is the clear indication for corticosteroids because they give the strongest anti-inflammatory effect on the inflamed myocardium and valves.
Step 3: Milder carditis without failure can be treated with either steroids or aspirin, steroids being favoured, and pure arthritis without cardiac signs is managed with aspirin alone over a course of roughly 12 weeks.
Step 4: Isolated chorea and subcutaneous nodules do not by themselves call for steroids, so the only firm steroid indication among the choices is carditis.
\[\boxed{\text{Carditis}}\]
Step 2: Carditis, particularly when accompanied by heart failure, is the clear indication for corticosteroids because they give the strongest anti-inflammatory effect on the inflamed myocardium and valves.
Step 3: Milder carditis without failure can be treated with either steroids or aspirin, steroids being favoured, and pure arthritis without cardiac signs is managed with aspirin alone over a course of roughly 12 weeks.
Step 4: Isolated chorea and subcutaneous nodules do not by themselves call for steroids, so the only firm steroid indication among the choices is carditis.
\[\boxed{\text{Carditis}}\]
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