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Year2 MSK exam2 > Juvenile Idiopathic Disease, Told, Part I > Flashcards

Juvenile Idiopathic Disease, Told, Part I Flashcards

1
Q

synonyms for juvenile arthritis

A

juvenile RA
juvenile chronic arthritis
juvenile idiopathic arthritis

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2
Q

Dx juvenile arthritis

A

by exclusion

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3
Q

demographics juvenile arthritis

A

< 9 years old

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4
Q

Criteria for Dx JIA

A

6 weeks
poly, pauci or systemic
exclusion of other forms juvenile arhtritis

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5
Q

ddx JIA

A

SLE, reactive, lymes, dermatomyositis, kawasaki
rheumatic fever, IBD, hematologic, vasculitis, septic arthritis, toxic synovitis hip
neoplasia
infantile onset multi systemic
psychogenic

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6
Q

Systemic onset of HIA

A

1+ joints

extra articular features 6+ weeks

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7
Q

pauciarticular JIA

A

subtype I: classic
II: spondylitic
III: psoriatic

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8
Q

nail and skin manifestation JIA

A

subtype III pauciarticular

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9
Q

Polyarticular JIA

A

RF+ or -

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10
Q

determinant of prognosis in polyarticular JIA

A

RF - is better prognosis

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11
Q

spondylitic JIA

A

enthesitis related

II pauciarticular

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12
Q

growing pains

A

6-13 y.o
thighs, calves, shins
late in day or night

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13
Q

Tx growing pains

A

heat massage and analgesics

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14
Q

Stills disease

A

systemic JIA

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15
Q

What are signs and Sx stills disease

A

malaise, rash, fever, adenopathy, HSM, serositis, hepatits, DIC, anemia

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16
Q

MSK Sx of stills

A

arthritis, myalgia, arthralgias

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17
Q

age of onset

A

< 5 F=M (most common)

>5 F>M

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18
Q

fever curve in systemic JIA

A

all over the place

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19
Q

rash in juvenile rheumatoid arthritis

A 
transient
salmon pink
circumscibed macular
2-6 mm or bigger, confluent
chest, axilla thighs and upper arms
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20
Q

does the rash in JRA itch

A

not usually

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21
Q

Labs for systemic JIA

A

ESR- high
CBC- anemia, leukocytosis and thrombocytosis
IgM RF -
ANA -

22
Q

age of onset compared to pronosis for systemic JIA

A

younger age of onset – worse prognosis

23
Q

what can occur in child with persistent JIA

A

amyloidosis

24
Q

management of systemic JIA

A 
splinting to prevent deformity
PT and OT
NSAID
corticosteroids
DMARDs
25
Q

MTX in child

A

can affect growth

26
Q

most common JIA subtype

A

pauciarticular subtype I

27
Q

clinical features subtype I pauciarticular JIA

A

ankle>elbow>hip)
early growth abnormalities
chronic uveitis within 5 years

28
Q

chornic uveitis in pauciarticular disease

A

subtype I

29
Q

labs for subtype I pauciarticular JIA

A

ESR increased or wnl
CBC wnl
RF -
ANA + 40-75%

30
Q

HLA assoc with subtype I pauciarticular JIA

A

HLA A2, DR5 DRw6 DRw8

31
Q

prognosis of subtype I pauciarticular JIA

A

early detection is key

long term good

32
Q

altered growth in subtype I pauciarticular JIA

A

iridocyclitis both eyes

33
Q

management pauciarticular disease subtype I

A 
splinting
PT OT
NSAIDs
local steroid injections
frequent ophthalmologic assessment
34
Q

juvenile spondlyoarthropathy

A

pauciarticular disease subtype II

35
Q

age of pauciarticular disease subtype II

A

> 9

M>F

36
Q

clinical features pauciarticular disease subtype II

A 
peripheral arthritis in  LE
enthesopathies
acute iritis
SI pain
axial disease
37
Q

presenting signs in pauciarticular disease subtype II

A

SI pain

axial disease

38
Q

labs in pauciarticular disease subtype II

A

ESR wnl to high
CBC wnl
RF -
HLA B27+!!!!

39
Q

course prognosis pauciarticular disease subtype II

A

good, some joint extension

1/3 develop spondylitis hip and cervical problems

40
Q

management pauciarticular disease subtype II

A 
PT and OT
posture training
NSAIDs
anti TNF agents
local corticosteroid injections
hip arthroplasty
ophthalmologic exam and follow up
41
Q

general characteristics pauciarticular JIA subtype III psoriatic

A

~8 years
F>M
FMH psoriasis
rarely systemic

42
Q

clinical features pauciarticular JIA subtype III psoriatic

A 
occasional severe destructive arthritis
dactylitis
asymmetric peripheral joint
psoriatic rash, nail pitting, onycholysis
flexor tenosynovitis
43
Q

what is dactylitis

A

swollen joint

44
Q

labs in pauciarticular JIA subtype III psoriatic

A

ESR varies, can be high
CBC Hb/Hct low, WBC inc
RF negative
ANA positive

45
Q

course and prognosis pauciarticular JIA subtype III psoriatic

A

young onset assoc with iritis
remitting and relapsing, even into adulthood
occasionally severely destructive
occasionally spondylitis develops

46
Q

management pauciarticular JIA subtype III psoriatic

A 
PT and OT
splinting
NSAIDs
may need immunosuppression (MTX)
biologic agents (anti TNG, IL-1ra)
47
Q

gen characteristics polyarticular JRA

A

> 5joints

30% JRA patients

48
Q

RF - polyarticular JIA

A 
M
any joint
reduced neck and TMJ ROM
flexor tenosynovitis
mild lymphadenopathy and HSM, low grade fever
49
Q

Labs in RF - polyarticular JIA

A

ESR inc
CBC anemia, leukocytosis, thrombocytosis
RF -
ANA sometimes +

50
Q

course and prognosis polyarticular JIA

A

variable, may be monocyclic but prolonged with good outcome

recurrent episodes tend to cause progressive deformities

51
Q

management polyarticular RF - JIA

A 
splinting to prevent deformity
PT OT maintain and improve joint and muscle function
NSAIDs
DMARDs
anti TNF agents

Year2 MSK exam2 (17 decks)

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