Bedside Flashcards
Main complication of kawasaki
Coronary aneurysm treated with aspirin to lower thrombocyte count and avoid thrombosis
Why can’t you treat kawaski in the winter with aspirin
Cause higher influenza rates can lead to Reye’s syndrome
In scleroderma the morphea can lead to
Contractures which can cause shortening of joints
What does synovial fluid usually look like? In septic arthritis?
Yellow usually. But in septic can be green or white
Most common pathogens in septic arthritis are
Staph and strep
How do you treat septic shock
Fluoxacillin
Why would you use US in septic arthritis
To look for pannus (thickening of synovial suggest chronic infection), look for local soft tissue inflammation, and extra synovium
What do you do extra in septic arthritis
MRI, can be used to look for a myolitis
Patient with otitis, that had a gastroenteritis/upper respiratory infection.
pain in ankles and knees. This was followed by skin lesions that covered the joints and butt.
Henoch scholein
What are there more skin lesions for the Henoch scholein patient on the butt
Gravity
What do you have to exclude in Henoch scholein patient? Check which organ
Check kidney and intestine. No blood in stool or urine. Have to watch for glomerulonephritis and intussusceptiondue to bowel inflammation
If Henoch scholein involves kidney it can cause? Needs to be control by?
IgA nephropathly and needs to be controlled by
Treating Henoch scholein if there is just skin symptoms? If you have edema of the skin or arthritis? If it effects kidney or GI?
- Skin=nothing, just observe.
- Edema=NSAIDS
- Kidney or GI involvement= steroid (with IV preferred over oral)
If treatment doesn’t help the patient what’s the next step?
Biopsy from artery on thigh or calf on active lesion to see if it is a full blown vasculitis. Then treat it with immunosuppressant.
What to give to patient on steroids
PPI for Cushing ulcer, potassium, and vitamin D plus calcium (to avoid bone absorption leading to tetany from low serum calcium)
