This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Rheumatic Fever, Subject name: Pathology
Pick the true statement about major criteria of Jones in acute rheumatic fever. 
Select and explain. 
A. Carditis is the earliest clinical manifestation seen in acute rheumatic fever, B. Sydenham chorea is a late manifestation, C. Involvement of small joints is a characteristic feature, D. Subcutaneous nodule are seen on flexor aspects of the limbs
B: Sydenham chorea is a late manifestation
Answer: B: Sydenham chorea is a late manifestation 
Explanation: Major criteria (Jones criteria for Acute Rheumatic fever) Carditis Clinical and/or subclinical Ahritis Polyahritis only Monoahritis or polyahritis or polyahralgia in moderate to high-risk populations Chorea Erythema marginatum Subcutaneous nodules There is a latent period of ~3 weeks (1-5 weeks) between the precipitating group A streptococcal infection and the appearance of the clinical features of ARF. The exceptions are chorea and indolent carditis, which may follow prolonged latent periods lasting up to 6 months. Syndenham's Chorea - commonly occurs in the absence of other manifestations, follows a prolonged latent period after group A streptococcal infection, and is found mainly in females. ARF almost always affects the large joints--most commonly the knees, ankles, hips, and elbows--and is asymmetric Subcutaneous nodules occur as painless, small (0.5-2 cm), mobile lumps beneath the skin overlying bony prominences (extensor surfaces).