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Musculoskeletal > Juvenile Idiopathic Arthritis > Flashcards

Juvenile Idiopathic Arthritis Flashcards

1
Q

3 types of JIA

A

Oligoarticular (55%)
Polyarticular (25%)
Systemic onset (20%

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2
Q

What is the most commonly diagnosed Rheumatic disease in children

A

Juvenile Idiopathic Arthritis

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3
Q

Describe pauciarticlar JIA

A

Most common type

4 or less joint involvement

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4
Q

Describe polyarticular JIA

how many joints and what % RF +ve/-ve

A

5 or more joint involvement
15% RF -ve
10% RF +ve

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5
Q

1st line Rx JIA

A

Simple pain killers

NSAIDs

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6
Q

Which DMARD is used in JIA

A

Methotrexate

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7
Q

Which 3 biologics are used to treat JIA

A

Anti-TNF
IL-1 R antagonist (Anakinra)
IL-6 Antagonist (Tocilizumab)

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8
Q

Indications for systemic steroids in JIA

A

Systemic JIA
Serious disease complications with any of the subtypes
Children undergoing surgery
Bridge between DMARD drugs

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9
Q

Side effects of steroids

A

Osteoporosis
Infections
Growth abnormalities
DM

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10
Q

Describe oligoarticular JIA

A

55% of JIA

4 or less joint involvement

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11
Q

Ix for JIA

A 
Examine 
Thorough history 
Rule out infection 
ESR 
ASO 
RF 
ANA
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12
Q

1st line rx for oligoarticular JIA

A

Simple pain killers

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13
Q

What is the main line Rx in oligoarticular JIA if 1 or 2 joints is affected

A

Local steroids

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14
Q

Criteria for Dx of JIA

A 
<16 years 
>6 week history 
Joint swelling + 2 of following:
Painful or limited joint motion 
Tenderness
Joint swelling
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15
Q

What are the two classifications for polyarticular JIA

A

RF-ve

RF +ve

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16
Q

Are majority of polyarticular RF -ve or +ve

A

RF -ve

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17
Q

Ix for JIA

A 
O/E 
History 
ESR 
CRP 
RF 
ANA
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18
Q

Rehabilitation for JIA options

A

Physio.

OT

19
Q

Surgical Rx for JIA

A

Synovectomy
Reconstructive
Joint replacement

20
Q

Symptoms of JIA

A

Young
Joint stiffness
Joint pain
Joint swelling

21
Q

Which other organ is commonly affected in JIA apart from the joints

A

Eyes

22
Q

Who does RF +ve polyarticular commonly affect

A

Girls

Older (12-16yrs)

23
Q

Who does RF -ve polyarticular commonly affect

A

Young girls

24
Q

Which eye condition is oligoarticular JIA commonly associated with

A

Uveitis

25
Q

Which joints does oligoarticular JIA typically affect

A

Large joints

E.g knee, ankle, wrist, elbow

26
Q

Which joints does polyarticular JIA typically affect

A

Typically symmetrical

Often involving small joints of the hand and feet

27
Q

Describe psoriatic JIA

A 
Usually presents with: Arthritis 
FH Psoriasis (1st degree)
Nail changes, and/or dactylitis; psoriatic rash may/may not be present.
28
Q

Who does enthesitis JIA typically affect

A

Boys 6

29
Q

Describe enthesitis JIA

A

affects boys over the age of 6 years and usually presents with asymmetrical arthritis, enthesitis, and sacro-iliac joint involvement.

30
Q

For which JIA would you tend to worry most about opthamological involvement

A

Oligoarticular

31
Q

Which is the least common JIA

A

Systemic onset

32
Q

Which is the most serious JIA

A

Systemic onset

33
Q

Describe RF and ANA generally in systemic JIA

A

RF -ve
ANA -ve
Generally

34
Q

Clinical features of Systemic JIA

A

Fever (characteristic)
Evanescent salmon pink macular rash
Lymphadenopathy
Joint involvement

35
Q

Does joint involvement for systemic JIA need to be present for a diagnosis

A

No not initially

36
Q

Describe the fever in systemic JIA

A

more of a high grade fever
Patterned fever
Can spike at the same time everyday or twice a day with spontaneous return to baseline

37
Q

What is another name for systemic JIA

A

Stills Disease

38
Q

What internal organ involvement can occur in systemic JIA

A 
Hepatosplenomegaly 
Generalised lymphadenopahty 
Polyserositis
Pericarditis 
Pleural effusion
39
Q

When do joint manifestations of systemic JIA occur

A

Within 3-12 months of rash/fever symptoms

40
Q

Which factor is enthesitis JIA commonly relied to

A

HLA-B27

41
Q

What FH could suggest enthesitis JIA

A

Ankylosing spondylitis

42
Q

What FH would suggest psoriatic JIA

A

FH of psoriasis

43
Q

What is enthesitis

A

Pain where bone meets tendon

44
Q

What is undifferentiated JIA

A

JIA presenting with features of more than one subtype

Musculoskeletal (13 decks)

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