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Paedicatrics 3 > Juvenile Idiopathic Arthritis > Flashcards

Juvenile Idiopathic Arthritis Flashcards

1
Q

What is Juvenile idiopathic arthritis?

A

Arthritis occurring in:
• Someone who is less than 16 years old
• Lasts for more than 6 weeks.

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2
Q

How long does the arthritis need to last to be classed as JIA?

A

Moe than 6 weeks

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3
Q

Who does JIA affect?

A

People below the age of 16

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4
Q

What are the key features of inflammatory arthritis?

A
  • Joint pain
  • Swelling
  • Stiffness.
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5
Q

What are the 5 main subtypes of JIA?

A
  • Systemic JIA
  • Polyarticular JIA
  • Oligoarticular JIA
  • Enthesitis related arthritis
  • Juvenile psoriatic arthritis
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6
Q

What is another name for systemic JIA?

A

Stills disease

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7
Q

What is the characteristic feature of stills disease

A

Salmon-pink rash

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8
Q

What are the other features of systemic arthritis?

A
  • pyrexia
  • lymphadenopathy
  • uveitis
  • anorexia and weight loss
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9
Q

What will be negative in someone with systemic JIA?

A

Antinuclear antibodies (ANA) and rheumatoid factors

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10
Q

What will be raised in someone with systemic JIA?

A

Inflammatory markers, with raised CRP, ESR, platelets and serum ferritin

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11
Q

What is the main complication of systemic JIA?

A

Macrophage activation syndrome (MAS)

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12
Q

How does macrophage activation syndrome present?

A
  • An acutely unwell child
  • Disseminated intravascular coagulation (DIC)
  • Anaemia
  • Thrombocytopenia
  • Bleeding
  • Non-blanching rash
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13
Q

What is a key features of macrophage activation syndrome?

A

A key investigation finding is a low ESR.

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14
Q

What skin feature is present with macrophage activation syndrome?

A

Non-blanching rash

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15
Q

What is Polyarticular JIA?

A

Idiopathic inflammatory arthritis in 5 joints or more.

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16
Q

How does polyarticular JIA present?

A

Symmetrical

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17
Q

Which joints does polyarticular JIA tend to affect?

A

Small joints of the hands and feet, as well as the large joints such as the hips and knees.

18
Q

What systemic features can present with polyarticular JIA?

A
  • Mild fever
  • Anaemia
  • Reduced growth
19
Q

Are systemic symptoms common with polyarticular JIA?

A

No

20
Q

What is the equivalent of polyarticular JIA in adults?

A

Rheumatoid arthritis

21
Q

What is negative with polyarticular arthritis?

A

Rheumatoid factor-seronegative

22
Q

What is another name for Oligoarticular JIA?

A

Pauciarticular JIA

23
Q

How many joints does Oligoarticular JIA affect?

A

4 joints or less.

24
Q

How many cases of JIA does oligoarticular arthritis make up?

A

60% of cases of JIA

25
Q

Which joints does oligoarticular arthritis affect?

A

Larger joints- Knee or ankle

26
Q

Who does oligoarticular arthritis typically affect?

A

Girls under the age of 6 years.

27
Q

How many joints does oligoarticular arthritis typically affect?

A

One- monoarthritic

28
Q

What is oligoarticular arthritis associated with?

A

Anterior uveitis

29
Q

Do patients with oligoarticular arthritis typically have systemic symptoms?

A

No

30
Q

What is usually positive in someone with oligoarticular arthritis?

A

ANA antibodies

31
Q

What is usually negative in someone with oligoarticular arthritis?

A

Rheumatoid factor

32
Q

In who is enthesitis-related arthritis more common?

A

More common in male children over 6 years.

33
Q

What is enthesitis-related arthritis a paediatric version of?

A

Seronegative spondyloarthropathy group of conditions that affect adults.

34
Q

What is enthesitis?

A

Inflammation of the insertion point of the tendon onto the bone

35
Q

What do the majority of patient with enthesitis-related arthritis have?

A

HLA-B27 gene

36
Q

What are potential signs and symptoms of enthesitis-related arthrtis?

A

Signs and symptoms of psoriasis- psoriatic plaques and nail pitting
Inflammatory bowel disease- intermitted diarrhoea and rectal bleeding

37
Q

What are patients with enthesitis-related arthritis prone to?

A

Anterior uveitis

38
Q

What is the treatment progression for JIA?

A
  • NSAIDs, such as ibuprofen
  • Steroids, either oral, intramuscular or intra-artricular in oligoarthritis
  • Disease modifying anti-rheumatic drugs (DMARDs), such as methotrexate, sulfasalazine and leflunomide
  • Biologic therapy, such as the tumour necrosis factor inhibitors etanercept, infliximab and adalimumab
39
Q

Which NSAID could you give for JIA?

A

Ibuprofen

40
Q

Which DMARD’s could you give for JIA?

A

Methotrexate
Sulfasalazine
Leflunomide

41
Q

Which biological therapies could you give for JIA?

A

Tumour necrosis factor inhibitors:
Etanercept
Infliximab
Adalimumab

42
Q

Which biological therapies could you give for JIA?

A

Tumour necrosis factor inhibitors:
Etanercept
Infliximab
Adalimumab

Paedicatrics 3 (26 decks)

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