Juvenile idiopathic arthritis Flashcards

1
Q

What are some diagnostic requirements for JIA?

A

Age <16
>6 weeks duration
Joint swelling and 2 of painful/limited joint movement, tenderness, or warmth

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2
Q

What are the 3 major subtypes of JIA?

A

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

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3
Q

What are some signs and symptoms of pauciarticular JIA?

A

Usually younger and female
Loss of function rather than pain (limp)
Lower limb more affected (knee, ankle)
Chronic uveitis association

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4
Q

Is pauciarticular JIA ANA positive?

A

Commonly yes

40-75%

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5
Q

What is ANA?

A

Antinuclear Antibody

ANA positive test could mean autoimmune disease

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6
Q

Can hips be affected in pauciarticular JIA?

A

Yes

Possible to develop AS or spondyloarthritis

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7
Q

Which category of JIA would present with HLA-B27 involvement and back involvement?

A

Juvenile ankylosing spondylitis

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8
Q

How many joints are involved in pauciarticular JIA?

A

1-4

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9
Q

How many joints are affected in polyarticular JIA?

A

5+

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10
Q

How does RF positive polyarticular JIA present?

A
Fever
Malaise
Hepato-splenomegaly
Mild anaemia
Growth abnormalities
Symmetric large and small joints affected
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11
Q

How does RF negative polyarticular JIA present?

A
Fever
Malaise
Weight loss
Anaemia
Nodules
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12
Q

Is uveitis common in polyarticular JIA?

A

No

Still possible so must be screened for

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13
Q

What condition must be screened for in all JIA?

A

Uveitis

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14
Q

What are some systemic complications of RF positive polyarticular JIA?

A
Sjorgen's
Felty
Vasuclitis
AR
Pulmonary fibrosis
Erosions on x ray
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15
Q

How does systemic onset JIA present?

A
Fever (rises daily for at least 2 weeks)
Salmon red rash on trunk and thighs
Lymphadenopathy
Hepatosplenomegaly
Abdominal pain
Serositis
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16
Q

Describe the rash associated with systemic onset JIA.

A

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

17
Q

What is Koebner’s phenonmenon?

A

Rash brought on by scratching

Present in systemic onset JIA

18
Q

What is a 1st line therapy option for JIA?

A

NSAIDs

Steroid injections

19
Q

What are some 2nd line treatment options for JIA?

A

Methotrexate
Anti-TNF
IL-1 R-antagonist
IL-6 antagonist

20
Q

What does anakinra do?

A

IL-1 R-antagonist

21
Q

What does tocilizumab do?

A

IL-6 antagonist

22
Q

What are some risk for steroid use in JIA?

A

Osteoporosis
Infection
Growth abnormality

23
Q

What are some options for JIA rehabilitation?

A

Physio

OT