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Pediatrics > Allergy > Flashcards

Allergy Flashcards

1
Q

increase symptoms at night suggest

A

Bedroom Allergens

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2
Q

Weekend remissions suggest

A

School place allergens

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3
Q

Eosinophil level suggestive of allergy

A

> 700/mm3 in blood
5 ~ 10 % in cells

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4
Q

IgE is considered……

A

good negative (sensitive not specific)

لو لقيته واطي اوي هقدر ا exclude atopy
بس لو لقيته عالي مش هقدر اعتمد عليه لوحده في التشخيص عشان بيبقى عالي في حاجات تانية

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5
Q

skin prick test is considered +ve when…..

A

a wheal of ≥ 3mm appears

indicates that IgE Ab is present on mast cells
doesn’t indicate that pateint will have symptoms on exposure of allergen

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6
Q

Provocation test vs skin prick

A

Provocation is more accurate but riskier

should only be done in hospitals

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7
Q

M/I line of ttt of allergy

A

Avoidance of allergen

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8
Q

SCIT

A

not approved before 5 years

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9
Q

SLIT

A

not available for food allergy

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10
Q

Atopy and breastfeeding

A

continue breastfeeding

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11
Q

m/c chronic inflammatory skin disorder

A

atopic dermatitis

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12
Q

Define JIA

A

arthritis of unknown etiology
begins before the 16th birthday
persists for at least 6 weeks
with other known conditions excluded

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13
Q

type of fever in Systemic JIA

A

Quotidian = intermittent

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14
Q

criteria of Systemic JIA

A

arthritis in ≥ 1 joint with history of 2 weeks fever that is quotidian for at least 3 days+ one of the following:
- Serositis ( eg. Pericardial effusion)
- Hepatomegaly or splenomegaly
- Generalized lymphadenopathy
- Evanescent erythematous rash

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15
Q

Criteria of psoriatic JIA

A

Arthritis + psoriasis or Arthritis + ≥ 1 of:
- Dactylitis
- Nail pitting / onycholysis
- 1st degree relative has psoriasis

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16
Q

criteria of enthesitis related JIA

A

arthritis + enthesitis or Arthritis / enthesitis + ≥ 2 of:
- Sacroiliac tenderness / inflammatory lumbosacral pain
- onset in male > 6 years old
- HLA-B27 +ve
- Acute anterior uveitis
- +ve FH

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17
Q

character of pain in JIA

A

Aching or streching
occurs on active or passive movement

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18
Q

joint stiffness improves by

A

activity or application of heat to the affected area

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19
Q

arthritis in the knee is characterized by

A

atrophy of Vastus Medialis

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20
Q

peak age of Systemic JIA

A

1 ~ 5 years (both genders are equally affected)

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21
Q

at which part of the day does fever occur

A

any time of the day but is characteristically present in the late afternoon to evening in conjunction with the rash

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22
Q

M/C location of skin rash in JIA

A

Trunk and proximal extremities
** NON PURITIC**
- elicited by Scratching / Hot bath / Psychological stress

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23
Q

M/C joints involved in systemic JIA

A
  • wrists
  • Knees
  • Ankles
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24
Q

Most devastating complication if JIA

A

Macrophage activation syndrome

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25
Q

MAS is characterized clinically by the rapid development of:

A
  • Unremitting fever
  • Hepatosplenomegaly and lymphadenopathy
  • Hepatic dysfunction (and even liver failure)
  • Encephalopathy
  • Purpura, bruising, and mucosal bleeding
  • Severe cases rapidly progress to multiorgan involvement , hypotension and shock.
26
Q

peak age of oligoarticular JIA

A

2-4 years with female predominance.

27
Q

Most common Joint involved in oligoarticular JIA

A

Knee

28
Q

If oligoarticular JIA + +ve ANA

A

search for chronic uveitis

29
Q

peak age of Polyarticular JIA

A

Rh-negative: 2-4 and 10-14 years
Rh-positive: 9-12 years
Female predominance

30
Q

Most common joint affected in polyarticular JIA

A

small joints of the hands, feet, ankles, wrists,
and knees

31
Q

TMJ arthritis leads to

A

Micrognathia

32
Q

Rheumatoid nodules are present in

A

severe Rh-positive polyarthritis

33
Q

Peak age of Enthesitis Related arthritis

A

9 ~ 12 years
male predominance

34
Q

character of The peripheral arthritis in ERA

A

oligoarticular, asymmetrical and mainly
involves the lower extremities.

35
Q

Most common joint affected in ERA

A

Hip

36
Q

Peak age of psoriatic JIA

A

2~4 and 9 ~ 11
female predominance

37
Q

Most common X-ray finding in Arthritis

A

periarticular osteopenia,

38
Q

Drug-induced Lupus

A
  • Anticonvulsants
  • Antiarrhythmics
  • Sulfa
    ** No major organ Involvement**
39
Q

Maternal Ab in neonatal Lupus

A
  • Anti Ro = Anti SSA
  • Anti La = Antia SSB
  • Anti RNP
40
Q

the most common inflammatory
myositis in children

A

Juvenile dermatomyositis (JDM)

41
Q

Peak age at onset of Juvenile dermatomyositis (JDM)

A

4 ~ 10 years
Femal predominance

42
Q

Shawl sign

A

Photosensitive erythematous skin rash in sun-exposed area; over upper chest and neck

43
Q

heliotrope rash

A

blue-violet discoloration
of the eyelids that may be associated with periorbital edema.

44
Q

Gottron papules

A

bright-pink or
pale, shiny, thickened or atrophic plaques
over the proximal interphalangeal joints
and
distal interphalangeal joints and
occasionally on the knees, elbows

45
Q

character of fever in Kawasaki Disease

A

high spiking (≥38.3°C )
unremitting
unresponsive to antipyretics
The duration of fever without treatment is generally 1-2 wk but may be as
short as 5 days or may persist for 3-4 wk

46
Q

Criteria of Kawasaki disease

A

(1) bilateral nonexudative conjunctival injection with limbal sparing
(2) erythema of the oral and pharyngeal mucosa with strawberry tongue and red,
cracked lips
(3) edema (induration) and erythema of the hands and feet
(4) rash of various forms (maculopapular, erythema multiforme, scarlatiniform or less
often psoriatic-like, urticarial or micropustular), and
(5) nonsuppurative cervical lymphadenopathy, usually unilateral, with node size >1.5
cm.

47
Q

duration of Acute phase of KD

A

1 ~ 2 weeks
Perineal desquamation is common

48
Q

duration of Subacute phase of KD

A

3 Weeks
associated with desquamation, thrombocytosis, development of CAA
High risk of sudden death

49
Q

duration of Convalescent phase of KD

A

6 ~ 8 weeks after onset
continues until ESR is back to normal

50
Q

diagnosing KD requires

A

the presence of fever for at least 4
days
and at least 4 of 5 of the other principal characteristics of the illness

51
Q

diagnosing KD should be done within

A

7 ~ 10 days
to improve coronary artery outcomes

52
Q

CBC in KD

A
  1. ↑ TLC (Neutrophils predominant)
  2. Normocytic Normochromic anemia
  3. Platelets normal in 1st week
    rapidly increasing in 2nd and 3rd week
53
Q

TTT of KD

A
  • 2 g/kg of IVIG as a single infusion,
    administered over 10-12 hrs
    ASAP when diagnosis is established
  • Aspirin
54
Q

Aspirin in KD

A
  1. Moderate to High dose until patient is afebrile
  2. Lowered from anti-inflammatory to antithrombotic dose when afebrile for 48 h
  3. discontinued after 6 ~ 8 weeks of disease onset
55
Q

Most common vasculitis in childhood

A

Henoch-Schönlein purpura

56
Q

duration of rash in HSP

A

3 ~ 10 days
recur after 4 months

57
Q

cause of FMF

A

AR
mutations in MEFV gene
Homozygosity for the M694V mutation with earlier onset

58
Q

The hallmark cutaneous finding in FMF

A

erysipeloid erythematous rash that overlies the ankle or dorsum of the foot

59
Q

most common cause of acquired Heart disease in developed countries

A

Kawasaki disease

60
Q

Most significant ccc of Kawasaki disease

A

Coronary artery aneurysm

61
Q

When to suspect SCID

A

ALC< 3000x103/uL at birth
❑2800x103/uL during infancy

62
Q
A

Pediatrics (5 decks)

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