JIA

Question 1

diagnosed where there is

Answer 1

arthritis w/o any other cause lasting >6wks in patient <16yrs

Question 2

key features inflammatory arthritis

Answer 2

joint pain
swelling
stiffness

Question 3

systemic JIA: aka

Answer 3

still’s disease

Question 4

systemic JIA: features

Answer 4

salmon-pink rash 
high swinging fevers
enlarged lymph nodes
weight loss
joint inflammation and pain 
splenomegaly 
muscle pain 
pleuritis
pericarditis

Question 5

systemic JIA: blood results

Answer 5

ANA and RF usually -ve

raised inflammatory markers: CRP, ESR, platelets

Question 6

systemic JIA: key complication

Answer 6

macrophage activation syndrome

Question 7

macrophage activation syndrome: what

Answer 7

severe activation of immune system with massive inflammatory response

Question 8

macrophage activation syndrome: presentation

Answer 8

acutely unwell child 
DIC
anaemia 
thrombocytopenia 
bleeding

Question 9

macrophage activation syndrome: key investigation finding

Answer 9

low ESR

Question 10

non-infective differentials for kid with fever > 5 days

Answer 10

kawasaki disease
systemic JIA
rheumatic fever
leukaemia

Question 11

polyarticular JIA: what

Answer 11

idiopathic inflammatory arthritis in ≥5 joints

Question 12

polyarticular JIA: systemic symptoms

Answer 12

mild

mild fever, anaemia, reduced growth

Question 13

polyarticular JIA: seronegative

Answer 13

negative RF

Question 14

polyarticular JIA: seropositive

Answer 14

positive RF

usually older children and adolescents
disease pattern more similar to RA in adults

Question 15

oligoarticular JIA: aka

Answer 15

pauciarticular JIA

Question 16

oligoarticular JIA: what

Answer 16

involves 4 joints or less

usually only one joint

Question 17

oligoarticular JIA: tends to affect

Answer 17

larger joints

girls < 6yrs

Question 18

oligoarticular JIA: classic assoc feature

Answer 18

anterior uveitis

Question 19

oligoarticular JIA: antibodies

Answer 19

ANA usually +

RF usually -

Question 20

enthesitis related arthritis: what

Answer 20

paediatric version of seronegative spondyloarthropathy group affecting adults

Question 21

juvenile psoriatic arthritis: what

Answer 21

seronegative inflammatory arthritis assoc with psoriasis

Question 22

juvenile psoriatic arthritis: pattern

Answer 22

can be symmetrical affecting small joints
or
assymetrical affecting large joints

Question 23

juvenile psoriatic arthritis: signs OE

Answer 23

psoriatic plaques
nail pitting 
onycholysis 
dactylitis
enthesitis

Question 24

Mx JIA

Answer 24

NSAIDs
steroids: oral, IM, IA
DMARDs
biologics - etanercept, infliximab