Brainscape's Knowledge GenomeTM

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


See full index

MSK > Juvenile idiopathic arthritis > Flashcards

Juvenile idiopathic arthritis Flashcards

1
Q

What is JIA?

A

Group of inflammatory disorders affecting children below 16yrs

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

What is the most commonly diagnosed rheumatic disease in children?

A

JIA

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

What type of disease is JIA?

A

Autoimmune

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

What is the etiology and pathogenesis of JIA?

A

Genetic
Environmental
Immunologic
= multi-factorial

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

What is the criteria for diagnosis for JIA?

A

Age of onset = <16yrs
Duration of disease = >6wks
Presence of arthritis = joint swelling or 2 of the following: painful of limited joint motion, tenderness, warmth

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

After 6mo, what are the 3 major subtypes of JIA?

A

Pauciarticular
Polyarticular
Systemic onset

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

Why do the clinical subtypes of JIA matter?

A

Help suspect natural history
Complications
Prognosis
Strategy of treatment

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

What is the most common subtype of JIA?

A

Pauciarticular

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

What is the mean onset age for pauciarticular JIA?

A

2-4yrs

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

Which sex is more affected in type I pauciarticular JIA?

A

Female

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

How many joints does pauciarticular JIA affect?

A

4 or less joints

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

What is the presentation of type I pauciarticular JIA?

A

Limp rather than pain

No constitutional manifestations

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

What types of joint does type I pauciarticular JIA affect?

A

Knee, ankle, hand/elbow

Hip = rare

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

What joint is rarely affected in pauciarticular JIA?

A

Hip

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

Is type I pauciarticular JIA usually ANA-positive or negative?

A

+ve ANA

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

What is a common complication in 20% cases of type I pauciarticular JIA?

A

Chronic uveitis

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

How many types of pauciarticular JIA are there?

A

3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which sex is more affected in type II pauciarticular JIA?

A

Males

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

What is the mean age for onset of type II pauciarticular JIA?

A

After 8/9yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the presentation for type II pauciarticular JIA?

A

Constitutional rare
Limp
Knee, ankle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is a complication in 10-20% cases of type II pauciarticular JIA?

A

Acute iridocyclitis - vision blurred, eyes red

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which sex is more affected in type III pauciarticular JIA?

A

Females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the mean age for onset of type III pauciarticular JIA?

A

Any age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the presentation for type III pauciarticular JIA?

A

Asymmetric UL and LL arthritis

Dactyltitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What psoraisis like in type III pauciarticular JIA?

A

FHx psoriasis 40%
+/- nail pitting
May develop psoriasis later in life

26
Q

How many joints does polyarticular JIA affect?

A

5 or more joints

27
Q

Is polyarticular JIA RF-ve or +ve?

A

Either

28
Q

What is the age of onset for RH-ve polyarticular JIA?

A

Any age, often early

29
Q

Which sex is more affected in RH-ve polyarticular JIA?

A

Female

30
Q

What is the presentation of RH-ve polyarticular JIA?

A

Constitutional manifestations: low grade fever, malaise
Hepato-splenomegaly
Mild anaemia
Growth abnormalities

31
Q

What joints does RH-ve polyartciular JIA affect?

A

Symmetric large and small joints:

knees, wrists, ankles, MCPs, PIPs, neck

32
Q

What is the age of onset for RH+ve polyarticular JIA?

A

Late childhood, teens, 12-16yrs

33
Q

Which sex is more affected in RH+ve polyarticular JIA?

A

Female

34
Q

What is the presentation of RH+ve polyarticular JIA?

A

Constitutional manifestions: low grade fever, malaise, weight loss
Anaemia
Nodules

35
Q

What can complicate RH+ve polyarticular JIA?

A 
Sjogren's, Felty or vasculitis
AR (aortic regurgitation)
Pulmonary fibrosis
AAS (acute aortic syndrome)
CTS (carpal tunnel)
36
Q

Which type of RH JIA is similar to RA but in a child?

A

RH+ve

37
Q

What is the least common type of JIA?

A

Systemic onset

38
Q

What is systemic onset JIA also known as?

A

Still’s disease

39
Q

What defines systemic onset JIA?

A

Extra-articular features

40
Q

What is the age of onset for systemic onset JIA?

A

Throughout childhood (4-6yrs)

41
Q

What are the extra-articular features of systemic onset JIA?

A 
Fever
Rash
Lymph nodes
Hepatosplenomegaly
Abdominal pain
Serositis
Rare: pleural effusion/pulmonary fibrosis
Arthritis
42
Q

What are the features of fever in systemic onset JIA?

A

Rise to 39.5 daily for at least 2wks
Late in afternoon evening/normal morning
Child appear bad with fever/chills, then normal when fever gone

43
Q

What are the features of rash in systemic onset JIA?

A

Evanescent salmon red eruption
On trunk and thighs
Accompanies fever
Can be brought by scratching

44
Q

What are the features of lymph nodes in systemic onset JIA?

A

Generalised lymphadenopathy

Non tender

45
Q

What are rare pulmonary manifestations of systemic onset JIA?

A

Pleural effusion

Pulmonary fibrosis

46
Q

What are the features of arthritis in systemic onset JIA?

A

Within 3-12mo of onset of fever

Wrists, knees, ankles, cervical spine, hips, TMJ

47
Q

What type of JIA sees higher levels of uveitis?

A

Pauciarticular/oligoarticular JIA

48
Q

Is uveitis related to ANA-ve or +ve?

A

ANA +ve

49
Q

What is the most common non-infective cause of uveitis?

A

JIA

50
Q

What are complications of uveitis in JIA?

A

Posterior synechiae
Cataract
Band keratopathy

51
Q

What is important to do in children with JIA?

A

Screening for uveitis

52
Q

What is the treatment for uveitis?

A 
Steroids
Mydriatic and cycloplegia agents
Methotrexate
MMF
Ciclosporin
Anti-TNF
53
Q

What is the 1st line therapy for JIA?

A

Pain killers

NSAIDs

54
Q

What is the 2nd line therapy for JIA if no response to NSAIDs/joint injections?

A

Methotrexate
Anti-TNF
IL therapy

55
Q

What are systemic steroids used in in JIA?

A

Systemic JIA
Serious disease complications
Bridge between DMARDs
Undergoing surgery

56
Q

What are the risks of systemic steroids?

A

Osteoporosis
Infections
Growth abnormalities

57
Q

What are other treatments for JIA apart from pharmacological?

A

Physio

OT

58
Q

What type of JIA uses local steroids?

A 
Oligo/pauci-articular JIA
Eye disease (ANA+ve oligoarticular disease)
59
Q

What are surgical options for JIA?

A

Synovectomy

Reconstructive/joint replacement surgery

60
Q

What are growth failures in JIA?

A 
Leg length discrepencies
Shortening of fingers, hands, forearms, toes, feeet
Micrognathia
Short stature
Delayed puberty

MSK (17 decks)

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