Collagen, Vascular, Rheuma

Question 0

True of Juvenile Rheumatoid Arthritis:
​a. migratory polyarthritis
​b. involves hip joints
​c. (di maalala)
​d. (di maalala)

Answer 0

NTP: Initial symptoms may be subtle or acute, and often include morning stiffness and gelling, easy fatigability, particularly after school in the early afternoon, joint pain later in the day, and objective joint swelling. The involved joints are often warm, resist full range of motion, are painful on motion, but are not usually erythematous. Oligoarthritis (pauciarticular disease) predominantly affects the joints of the lower extremities, such as the knees and ankles ( Fig. 154-3 ). Often, only a single joint is involved at onset. Isolated involvement of upper extremity large joints is not characteristic of this type of onset. Involvement of the hip is almost never a presenting sign of JRA. Hip disease may occur later, particularly in polyarticular JRA, and is often a component of a deteriorating functional course.

Question 1

Predicts progression of SLE:
​a. ANA and DNA
​b. ANA
​c. DNA
​d. C3

Answer 1

C. DNA

Nelsons 19th in SLE and Laboratory Findings: Elevated ANA titers are often present in children with active SLE. This is an excellent screening tool, although ANA can be found without any disease or can be associated with rheumatic and other conditions. Levels of anti-double-stranded DNA, which are more specific for lupus, reflect the degree of disease activity. Serum levels of total hemolytic complement (CH50), C3, and C4 are decreased in active disease and provide a second measure of disease activity. Anti-Smith antibody, found specifically in patients with SLE, does not measure disease activity.

Question 2

Hallmark of SLE 
A. 
B. Circulating autoantibodies 
C. 
D.

Answer 2

B NTP19 Ch 152
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multisystem inflammation and the presence of circulating autoantibodies directed against self-antigens.

Question 3

SLE occurs in  
A. Prepubertal  
B. Pubertal 
C. Reproductive 
D.

Answer 3

C NTP19 Ch 152 Systemic lupus erythematosus

SLE occurs in children and adults, disproportionately affecting women of reproductive age.

Question 4

22. Px with arthritis. Culture revealed Staph aureus. Stepdown med?
    a. Amoxicillin
    b. Cephalexin

Answer 4

b? Cephalexin
Amoxicillin is for penicillinase-susceptible B-lactam: gram positive pathogens except Staphylococcus. P.2485
No cloxacillin in the choices