Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Lizanne Peds NM > JIA > Flashcards

JIA Flashcards

1
Q

Diagnosis by ARA

A

Onset before 16
Sx must persist min 6 weeks
Arthritis in 1 or more joints (defined as swelling within a joint or limitation in the ROM with joint pain or tenderness)
Exclusion of other diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Etiology

A

Autoimmune, multifactorial inheritance (genetics + environmental trigger), involvement of T-cells & HLA genes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Is there a lab test to diagnose JIA?

A

No.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When does a child get assigned to a subtype?

A

After 6 mo of active disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 7 subtypes?

A 
Oligoarticular persistent and extended
Seronegative Polyarticular
Seropositive Polyarticular
Systemic
Psoriatric
Enthesitis
Undifferentiated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How many joints are affected in Oligoarticular JIA

A

4 or fewer (50% have only 1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What joints are often affected with Oligoarticular JIA?

A

KNEE, ankle, wrist (often asymmetric joint involvement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the most common kind of JIA?

A

Oligoarticular JIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What other condition is common with Oligoarticular JIA?

A

Iridocyclitis (anterior uveitis) - may be asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Persistent Oligoarticular JIA?

A

Affects no more than 4 joints throughout the course of the disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is Extended Oligoarticular JIA?

A

Affects more than 4 joints after the first 6 mo of the disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How many joints need to be affected to be considered Polyarticular JIA?

A

5 or more joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What joints are affected in Polyarticular JIA?

A

Knees, ankles, elbows, wrists, cervical spine and TMJ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the subtypes of Polyarticular JIA?

A

Seronegative (RF-) & Seropositive (RF+)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Peak ages and type of joint involvement in Seronegative Polyarticular JIA

A

2-4 & 6-12 y.o.

ASYMMETRIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Peak ages and type of joint involvement in Seropositive Polyarticular JIA

A

Girls in late childhood/early adolescence.
SYMMETRIC - similar to adult RA
(wrists/small joints in hands/feet)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Severe constitutional symptoms of Systemic JIA

A 
High Spiking fever
Salmon colored rash (tunk/proximal extremities)
Hepatosplenomegaly
Pleuritis
Pericarditis
Lymphadenopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the life threatening syndrome associated with Systemic JIA?

A

MAS (macrophage activation system) - activation of T cells and macrophages leads to overwhelming inflammatory response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When does joint pain develop with Systemic JIA?

A

Later in the process. 25-50% develop significant joint destruction

20
Q

Common clinical manifestations

A 
Morning "gelling"/after immobility
IL-1 & tumor necrosis factor alpha (mediates joint damage)
Pannus formation 
Ligamentous Laxity
Decreased ROM
Dec Physical Activity/Weakness
Osteopenia
Growth disturbance
Micrognathia
21
Q

Medical Treatment

A 
NSAID
DMARDS (methotrexate)
Anti-malarial (Plaquenil)
Gold Salts
Corticosteroids
Biologic Agents
22
Q

Methotrexate

A

Gold standard, Treats all types except systemic

23
Q

What is inactive disease?

A 
No joints with active arthritis
No fever, rash, serositis
No active uveitis/eye inflammation
Normal CRP and ESR
No disease activity on physician global assessment of disease activity
24
Q

What is clinical remission on medication?

A

criteria for inactive disease are met for a minimum of 6 continuous months while on meds

25
Q

What is clinical remission off medication?

A

criteria for inactive disease are met for a minimum of 12 continuous months off meds

26
Q

Whats one of the first things a parent might notice with JIA?

A

Decreased activity, not wanting to play etc (d/t pain)

27
Q

Pediatric pain scales

A 
NIPS - babies
FLACC- birth+, developmentally delayed (excluding paralyzed or those with spasticity) 
Oucher - ages 3 to 12
Faces Pain Rating Scale
VAS
COMFORT - unconscious/ventilator
28
Q

What should you assess with a child with JIA?

A 
The joint (look, feel, move, test)
ROM
Muscle strength (Observation of functional skills, MMT, handheld dynamometer)
Posture/gait
Functional abilities
Physical Fitness
29
Q

What is the PEDI-CAT?

A

Computer Adaptive Test. 3 functional domains & responsibility domain (daily activities, mobility, social-cognitive)

30
Q

What is age range for the Wee-FIM?

A

6 mo - 7 years
may be used with children above 7 as long as their functional abilities (as measured by wee fim) are below those expected of children aged 7 who do not have disabilities

31
Q

How many items and what domains are on the wee-fim

A

18 items, Self care, mobility, cognition.

32
Q

What are the FIM levels?

A

No Helper
7 Complete Independence (timely, safe)
6 Modified ind (device)
Helper - Modified Dependence
5 Supervision (subject = 100%)
4 Minimal assistance (subject = 75% or more)
3 Moderate assistance (subject = 50% or more)
Helper - Complete Dependence
2 Maximal assistance (subject = 25% or more)
1 Total assistance (subject = less than 25%)

33
Q

Juvenile Arthritis Assessment Scale age range

A

7-16 y.o.

34
Q

What does Juvenile Arthritis Assessment Scale observe?

A

the child’s actual performance of typical activities under standardized conditions.
10 items - ADLs (dressing, picking up an object off the floor)

35
Q

What is teh Juvenile Arthritis Assessment Scale scale?

A 
0= task performed in less than or equal to criterion time
1= task performed in more time than the criterion time
2= unable to do the task
36
Q

Activities Scale for Kids (ASK) age range

A

5-15 years old

37
Q

What does ASK measure?

A

Measures physical disability and monitors functional change in children with limitations due to musculoskeletal disorders

38
Q

How many items are on ASK

A

30 items - scored 0-4

39
Q

What is the ASK scale?

A

0-4.
0 is with no problem and 4 is the child could not
(personal care, dressing, locomotion, play, standing, transfers, other skills)

40
Q

Physical Fitness in pts with JIA

A

Peak oxygen uptake reduced in comparison to healthy peers
Lower peak work rate, peak exercise HR and exercise time
Impaired aerobic capacity appears to be related to hypoactivity more so than the severity of the disease

41
Q

Recommendations for physical fitness in pts with JIA

A

2X/week

Moderate to vigorous intensity (60-85%max HR) for 45-60 minutes for at least 6-12 weeks

42
Q

Tx of acute active joint swelling: AROM

A

go to point of discomfort and hold
10 reps 2-3x day
Proper hand placement to isolate the joint without stressing other joints

43
Q

Tx of acute active joint swelling: isometric exercises

A

Submax contraction for 6 seconds for 5-6 reps

44
Q

Tx of acute active joint swelling: other

A

Pain management, splinting/casting, activity modification

45
Q

Tx: resolving joint inflammation

A

Progress home program
Antigravity activities
May add light resistance 8-10 reps against gravity without pain (TB, etc)
Aquatic therapy
Strengthening (observe joint protection principles)
Return to activity (consider appropriateness of activities)
Continue ROM exercises

Lizanne Peds NM (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions