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Peds PM&R > Connective Tissue Disorders > Flashcards

Connective Tissue Disorders Flashcards

1
Q

Burn Def

A

Permanent destruction of tissue proteins by an external agent

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2
Q

Etiology of Burns

A

Thermal: scald, direct flame, contact, explosion
Chemical
Electrical

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3
Q

1st Degree Burn

A 
Superficial epidermis
Redness
No blistering
Painful 1-3 days
No scarring
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4
Q

2nd Degree Burn (Superficial dermis)

A

Superficial partial thickness
Painful red blisers
Heals 7-14 days
Possible permanent scarring

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5
Q

2nd Degree Burn (Deep reticular dermis)

A 
Deep partial thickness
Painful, red, blisters
Possible white eschar
Hperemia
Scarring likely 
3-4 weeks
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6
Q

3rd Degree Burn

A 
Full thickness
Muscle, tendon or bone
Non-painful, white, brown, black or red
Possible amputation
Severe scarring
Grafting required
Heals weeks to months
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7
Q

% of total body surface area (TBSA)

A

Rule of 9’s
9% for each arm and head
18% for each leg, anterior trunk and posterior trunk

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8
Q

Burns that warrant hospitalization

A

2nd deg >10% BSA
3rd deg >2% BSA
Significant burns of hands, feet, face, joints or perineum
Self inflicted
Circumferential may predispose to vascular compromise
Explosion, inhalation or chemical burns may have organ trauma

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9
Q

Classic desired position for burn healing

A 
Neck extended
Shoulders ABD to 90 deg
Elbows ext
Forearms supinated
Wrist 15-20 degvext
Palms up
Fingers ext
Hips ABD 10-15 deg
Knees ext
Ankles dorsiflexed
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10
Q

Dermatomyositis

A

Inflammatory myopathy with characteristic skin rashes

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11
Q

Dermatomyositis Clinical Features

A

Proximal symmetric muscle weakness
Heliotrope rash and gottrons papules
Shawl sign
Calcinosis

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12
Q

Dermatomyositis labs

A

Inc CK, adolase or SGOT, LDH

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13
Q

EMG findings in Dermatomyositis

A 
Fibrillations
Positive sharp waves
Complex repetitive discharges
Short duration 
Low amp polyphasic motor unit potentials
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14
Q

Muscle bx in Dermatomyositis

A

Perivasicular and interfasicular infiltrates with fiber degeneration and regeneration

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15
Q

Tx of Dermatomyositis

A

Oral/IV steroids
MTX to shorten steroid course
Hydroxychloroquine for heliotrope rash
Diltiazem for Calcinosis

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16
Q

Juvenile rheumatoid/idiopathic arthritis (JR/IA)

A

Group of dz with chronic joint inflammation

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17
Q

Pauciarticular JRA

A

4 or

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18
Q

Pathogensesis of JRA

A

Chronic synovial inflammation with B lymphocytes
Macrophage and T lymphocyte invasion and cytokines release with further synovial proliferation
Pannus l/t joint destruction

19
Q

CF of Pauciarticular JRA

A

Typically larger joints (knees, wrist, ankles)

Affected knee often with quad muscle wasting, limping and flexing contracture

20
Q

Natural history of Pauciarticular JRA

A

Persistent swelling l/t progessivs muscle wasting, weakness around joint and muscle contracture

21
Q

Presentation of Pauciarticular JRA

A

Morning stiffness presents with dec play activity in the toddler
Prominent limping with stiffness, weakness and contracture a
Joint fullness and warmth

22
Q

Polyarticular JRA

A

Joint inflammation in 5 or more joints within first 6 mo of dz onset

23
Q

CF of Polyarticular JRA

A

Symmetrical arthritis of small joints (hands, feet, jaw and cervical spine)

24
Q

Natural history of Polyarticular JRA

A

Rapid progression of weakness and contractures possible
Pain can be severe
Decline in activity
Loss of joint movement

25
Q

Systemic JRA

A

Joint pain +/- swelling with associated spiking fever and evanescent rash

26
Q

CF of Systemic JRA

A 
Daily or twice daily fever
Fleeting linear rash during fever on trunk/extremities
Athralgia worse during fever
Generalized myalgia
Possible panserositis
Hepatosplenomegaly
Joint inflammation
Wt loss, nausea, fatigue 
Sx present for at least 6 weeks
27
Q

Pathogenesis of Kawasaki Dz

A

Severe vasculitis of all BV, predominantly affecting medium sized arteries with coronary artery predilection

28
Q

CF of Kawasaki Dz

A 
High fever up to 104 for 1-2 wk
Conjunctivitis
strawberry tongue
dry cracked lips
Rash
Enlarged LN
Edema of hands and feet
29
Q

Tx of Kawasaki Dz

A

IVIG w/in first 10 days of illness to dec risk of cardiac aneurysm
High dose ASA
Plasmapheresis if unresponsive to tx

30
Q

Cause of Lyme Dz

A

Spirochete, Borrelia burgdorferi, transmitted by tick Ixodes

31
Q

Cause of Babesiosis

A

Babesia microti

Can occur as confection with Lyme dz

32
Q

Early Localized Lyme Dz

A 
Annular rash: erythema migrans
7-14 days after bite
Uniform or target rash
Fever, malaise, myalgia and HA
Other: aseptic meningitis, carditis w/ heart block, papilledema, uveitis, focal neuro findings
33
Q

Late Lyme Dz

A 
Weeks to months after infection
Arthritis of large joints
Tertiary neurobirreliosis
Encephalitis
Polyneuritis
Memory problems
34
Q

Lyme dz labs

A 
IfM Ab inc at 6-8 wk
ELISA against Ab to B burgdorferi 
Western blot
Inc WBC, ESR, CSF protein
Cultures takes 4 wk
35
Q

Treatment of Lyme Dz

A

Doxycycline is DOC

Cefuroxime or ceftriaxone for children

36
Q

Rheumatic Fever

A

Multisystem inflammatory dz 2-3 wk after group A hemolytic strep infection

37
Q

Cause of Rheumatic Fever

A

Ab cross reactivity in the heart, skin, joints and brain

Ab formed against M proteinin group A strep

38
Q

Jones Major Criteria

A 
Cardiac involvement (pancarditis, murmur, CHF)
Migratory polyarthritis
Erythema marginatum
Subcutaneous nodules
Sydenham's chorea
39
Q

Rheumatic Fever Labs

A

ASO titers
DNase B (streptozyme)
Inc CRP, ESR and WBC

40
Q

Rheumatic Fever Tx

A

Penicillin

Prednisone for carditis/CHF

41
Q

Septic Arthritis

A

infection of a joint d/t bactermia

42
Q

MC joints involved in Septic Arthritis

A

Hips>Knees>SI joint in Peds

43
Q

Systemic Lupus Erythematosus CF

A 
Joint pain (fingers, hands, wrists, knees)
Arthritis
Pericarditis, myocarditis, endocarditis
Fatigue and malaise
Pulmonary dz
Fever
Skin rash (malar)
Seizures
44
Q

SLE Labs

A

ANA
Anti-ds DNA
Antiphospholipid Ab
Ani-Smith Ab

Peds PM&R (15 decks)

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