22 - 142 - KAWASAKI DISEASE Flashcards
This nail finding is seen during the 3rd to 6th week after illness
A. Onychomadesis
B. Terry nails
C. Splinter hemorrhage
D. Beau’s lines
D
Diagnostic criteria for classic kawaski disease includes the following except
A. Periungual desquamation
B. High spiking and intermittent fever >/= 5 days
C. Cervical lymphadenopathy >/= 1.5 cm
D. Bilateral exudative conjuctival injection
D
Least commonly identified clnical feature of KD
A. Conjuctival injection
B. Strawberry tongue
C. Cervical lymphadenopathy
D. Desquamation of the entire hand and foot
C
T/F: KD is more common in males
TRUE
T/F: KD has a higher attake rate in Japanese children who adopt a western diet and lifestyle
TRUE
T/F: Bullae, vesicles and ulcerations are seen in KD
FALSE
Peak time to detect coronary artery dilatation in KD
A. first week of fever
B. 6-8 weeks after fever onset
C. 2-3 weeks after fever onset
D. 4-6 weeks after fever onset
C
most common cause of acquired heart disease in children in developed nations
Kawasaki disease
KD affects all blood vessels in the body, but primarily damages what size of BV?
medium-sized muscular arteries such as the coronary arteries
In kawasaki disease, treatement with IVIG and aspirin should be initiated within how many days of fever?
First 10 days of fever
reduces the prevalence of coronary artery abnormalities from 25% in those treated with aspirin alone, to 5% in those who receive IVIG with aspirin.
Long-term complications of kawasaki
thrombosis and stenosis of the major coronary arteries with myocardial ischemia.
80% of KD patients occur in what age?
6 months to 5 years
Peak age of illness in KD
9 to 11 months
3 forms of kawasaki
- Morbilliform
- Targetoid
- Scarlatiniform
What primary lesions are not observed in kawasaki
Bullae, vesicles, ulcers
groin erythema and desquamation are commonly observed are frequently observed in what phase of kawasaki
Acute febrile phase
Classic periungual desquamation of the fingers and toes does not begin until how many weeks after fever begins
second to third week after fever begins, and can progress to involve the entire hand and foot
transverse lines across the fingernails (Beau lines) is apparent after how many weeks of illness
third to sixth week after illness
Fever characteristics in kawasaki
fever in KD is daily, high spiking, intermittent, and lasts for 1 to 2 weeks
3 stages of kawasaki
- Acute febrile
- Subacute
- begins when fever resolves and continues until all clinical features have normalized - Convalescent
- follows the subacute phase and continues until the erythrocyte sedimentation rate [ESR] normalizes, usually at 6 to 8 weeks after the onset of fever
Conjunctival injection in KD
Bilateral, nonexudative
There may be limbal sparing (Fig. 142-5). Photophobia is a common accompanying feature.
Oral findings in kawasaki
red, swollen, dry, cracked lips that may bleed (Fig. 142-6), a “strawberry” tongue, and erythema of the mouth and throat
Oral ulcers are not a feature of KD.
Associated Clinical Features of Kawasaki Disease
Three linked pathologic processes characteristic of KD vasculopathy
- neutrophilic necrotizing arteritis, which occurs in the first 2 weeks after fever onset;
- subacute/chronic vasculitis, which begins in the first 2 weeks but can persist for months to years and is comprised of lymphocytes (predominately CD8 T lymphocytes25 ), plasma cells (particularly immunoglobulin [Ig] A plasma cells26,27 ), eosinophils, and macrophages; and
- luminal myofibroblastic proliferation, which is closely associated with subacute/chronic vasculitis and can result in progressive arterial stenosis
