Brainscape's Knowledge GenomeTM

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


See full index

Rheum > juvenile arthritis > Flashcards

juvenile arthritis Flashcards

1
Q

rubor common in joint inflammation in JIA

A

nope, no redness

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

Arthritis:

  1. calor (warmth)
  2. rubor (redness)
  3. tumor (swelling)
  4. dolor (pain)
  5. loss of function (decreased range of motion and stiffness
A

Arthritis: at least 2 out of 5 signs are present

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

JIA

  1. Onset of disease
  2. Diagnosis of
  3. Duration of arthritis
A
  1. Onset of disease < 16 yrs old (Juvenile)
  2. Diagnosis of exclusion (Idiopathic)
    infections, malignancies, other rheumatic conditions, metabolic/genetic syndromes
  3. Duration of arthritis >6 weeks (Chronic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

physical impact of JIA

A

joint overgrowth, muscular atrophy, micrognathia, joint flexion and contracture, boney erosions (requires more aggressive treatment)

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

what type of ankylosis do we see in JIA

A

loss of cervical lordosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Leg Length Measurement

A

From Anterior superior iliac spine (ASIS) to medial malleolus; A difference of greater than 1 to 2 cm is likely functionally significant

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

JIA classification most common

A

oligoarticular JIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q 
Polyarticular JIA (30-35%) 
RF (+)  associated with
A

seropositive RA

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

Enthesitis Related Arthritis (5-15%)
Juvenile Ankylosing Spondylitis
associated with

A

spondyloarthropathy

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

Juvenile Psoriatic Arthritis (7-8%)

A

psoriatic arthritis

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

what is the clinical pearl of oligoarticular JIA

A

Closely watch the eyes!

Uveitis

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

< 4 joints in the first 6 months after onset
Often in toddlers (1~2 year-old)
More in girls (F:M = 3:1)

Normal or mildly elevated inflammatory markers
Often has a positive ANA

A

oligoarticular JIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q 
> 5 joints in first 6 months of disease
Often in teen females
Small and large joints; symmetrical
Auto-antibodies:
RF 
anti-CCP
rarely +ANA
A

RF+ polyarticular JIA

Similar to RA in adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q 
>= 5 joint in first 6 months of disease
Large and small joints
Can be asymmetrical
Also watch for uveitis!
Similar to oligoarticular JIA except for joint counts
Response to treatment/outcomes
Risk of uveitis
A

RF - polyarticular JIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q 
Fevers for >2 weeks
	-Quotidian fevers (similar time of the day)
Arthritis
Typical rash
Lymphadenopathy
Hepatosplenomegaly
Serositis: pleural effusion, pericardial effusion
auto-inflammatory
A

systemic JIA

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

what types of rash do we see in systemic JIA (not specific)

A

evanescent rash and koebner phenomenon

17
Q

SJIA labs

A

increases levels of C reactive protein, ESR, ferritin, D-dimer, AST, ALT and cell counts such as WBC and PLT

18
Q

A severe complication, life threatening

7% of sJIA, also reported in other conditions

Excessive activation and expansion of
T lymphocytes
macrophagic histiocytes (hemophagocytic activity)

A

macrophage activation syndrome (MAS)

19
Q

difference in clinical labs between SJIA and MAS

A

MAS has low ESR, WBC and PLT

20
Q 
More often in older boys
Arthritis, Enthesitis
Risk of ankylosis
HLA-B27 associated
Acute Anterior Uveitis
A

ENTHESITIS RELATED ARTHRITIS

21
Q

enthesitis

A

inflammation of the tendon

22
Q

Only half patients have psoriatic rash
Dactylitis (Sausage finger/toe): often in young children
Nail changes (pitting, onycholysis)
Family history of psoriasis in a 1st degree relative

A

JUVENILE PSORIATIC ARTHRITIS

23
Q

Iridocyclitis

A

Inflammation of the anterior uvea (Iris, Ciliary body)

24
Q

high risk patients for chronic uveitis

A
  • female
  • oligoarticular JIA
  • RF (-) polyarticular JIA
  • Juvenile Psoriatic Arthritis
25
Q

band keratopathy

A

calcium deposits that blocks the pupil and one becomes blind

26
Q 
Painful, red, photophobic
Associated with HLA-B27
7-8% of ERA cases
Some seen in psoriatic arthritis
Low risk of complications due to symptomatic
A

acute uveitis

27
Q

high risk for acute uveitis

A

Enthesitis Related Arthritis

Juvenile Psoriatic Arthritis

28
Q

laboratory workup

A

not for diagnosis just t make sure that there are no contraindications for medications or if there is need for aggressive treatment

29
Q

early aggressive treatment allows for

A

early remission

30
Q

systemic JIA treatement

A

anti-IL1 and anti- IL6

31
Q

Most children never achieve a long-term remission

A

yep

Outcomes of JIA not as optimistic as before

32
Q

What joint is the most commonly involved in JIA?

A

knee

33
Q

Who is at higher risk developing chronic uveitis, the 16 yo girl with enthesitis related arthritis or the 4 yo boy with psoriatic arthritis?

A

4 yo boy with psoriatic arthritis

34
Q

Why we sometimes are concerned about “normalizing labs” in a febrile patient?

A

Complication of Macrophage Activation Syndrome

35
Q

A 14 yo boy has chronic joint pain in his hands, knees, low back and ankles, with swollen fingers, knees and ankles. If the family only agrees to take x rays at one site, which site do you choose?

A

X rays of low back to include Sacroiliac joints

36
Q

A 3 yo girl with oligoarticular JIA is doing very well off medications. You last saw her 6 months ago. She has been well without seeing any other doctors since then…Is there a problem?

A

She should be seen by her ophthalmologist every 3 months!!!

37
Q

medications in JIA

A

NSAIDs (naproxen), DMARDs (methotrexate), Biologic DMARDs (anti-TNFs), and corticosteroids (joint injections)

Rheum (13 decks)

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