Ch 10 - Peds: CTD, Burns, Cancer

Question 1

What is the MC connective tissue disorder in children?

Answer 1

Juvenile RA

Question 2

Describe Iridocyclitis in pauciarticular type I RA.

Answer 2

50% chronic

Question 3

Describe Iridocyclitis in pauciarticular type II RA.

Answer 3

10-20% acute

Question 4

Describe HLA studies in pauciarticular type II RA.

Answer 4

HLA-B27

Question 5

Why is ASA not used in children?

Answer 5

Risk of Reye’s syndrome with influenza and varicella infections

Question 6

What are approved NSAIDs for children?

Answer 6

Naproxen
Ibuprofen
Tolmetin

Question 7

What joints are involved in JRA?

Answer 7

Cervical spine (AA joint)
TMJ 50%
Shoulder
Elbow
Wrist
Hand
Hips 50% of polyarticular JRA
Knee
Ankle/foot

Question 8

What are the clinical features of Juvenile Dermatomyositis?

Answer 8

Histologic presence of vasculitis
Onset of calcinosis
No association with malignancy in childhood
MC girls 5-14 yo

Question 9

What is Morphea?

Answer 9

Localized form of scleroderma that is limited to skin
Small lesions occur with minimal sclerosis (guttate morphea)
Self-limiting: 2 to 3 years

Question 10

What are the Major Jones Criteria for Rheumatic fever?

Answer 10

Carditis
Polyarthritis
Chorea
Erythema marginatum
Subcutaneous nodules

Question 11

What are the Minor Jones Criteria for Rheumatic fever?

Answer 11

Fever
Arthralgia
Inc ESR or CRP
Prolonged PR interval

Question 12

What is needed to diagnose Rheumatic fever?

Answer 12

2 of the major criteria, or 1 major and 2 minor criteria, are required for diagnosis with evidence of preceding streptococcal group A infection

Question 13

What is the hallmark of hemophilia?

Answer 13

Hemarthrosis

Question 14

What is Kawasaki’s disease?

Answer 14

Infantile polyarteritis

Systemic vasculitis in <4 yo

Question 15

What are diagnostic criteria for Kawasaki’s disease?

Answer 15

• High grade fevers >5 days
• Strawberry tongue
• Bright red, chapped lips
• Pharyngeal erythema
• Conjunctival injection
• Edema of the hands or feet
• Erythema of the palms or soles with desquamation in later stages
• Truncal rash
• Cervical lymphadenopathy

Question 16

What is the MCC of pediatric burns?

Answer 16

Scald burns

Question 17

What is the rule of 9’s for ages 1-4?

Answer 17

Head: 19
Torso: 32
Arm: 9 each
Leg: 15 each

Question 18

What is the rule of 9’s for ages 5-14?

Answer 18

Head: 13
Torso: 32
Arm: 9 each
Leg: 18 each

Question 19

What is the rule of 9’s for adults?

Answer 19

Head: 10
Torso: 36
Arm: 9 each
Leg: 18 each

Question 20

What does comfort lead to in a burn patient?

Answer 20

Contracture

Question 21

What is the 2nd MC childhood cancer?

Answer 21

Brain tumors

50% posterior fossa

Question 22

What is non-Hodgkin Lymphoma caused by?

Answer 22

Epstein–Barr virus

Question 23

What is the 3rd MC childhood cancer in <5 yo?

Answer 23

Neuroblastoma

Question 24

What are the MC abdominal masses in early childhood?

Answer 24

Hydronephrosis
Neuroblastoma
Wilm’s tumor.

Question 25

What is the most common malignant soft-tissue tumor in children?

Answer 25

Rhabdomyosarcoma

Question 26

What are the most common bone tumors in children?

Answer 26

Osteosarcoma followed by Ewing’s sarcoma

MC >10 yo

Question 27

Location of Osteosarcoma

Answer 27

Arises in the metaphysis of long bones

MC at distal femur followed by the proximal tibia and proximal humerus

Question 28

Location of Ewing’s sarcoma

Answer 28

Arises in long and flat bones including the pelvis and most typically in the diaphysis