Kawasaki Disease - MEDIUM CELL Flashcards
Kawasaki disease is a type of vasculitis that commonly affects the medium size vessels. Does this commonly affect adults or children?
- children
- typically 1-5 year olds, peaks at 2-3 years
Leading cause of acquired heart disease in children affecting around 300/year in the UK
What is the incidence of Kawasaki disease in the UK?
1 - 0.8 : 100,000
2 - 8 : 100,000
3 - 800 : 100,000
4 - 8000 : 100,000
2 - 8 : 100,000
2nd most common vasculitis in children
Which nationality is most commonly affected by Kawasaki disease?
1 - Caucasians
2 - African Americans
3 - Europeans
4 - Southeast asians
4 - Southeast asians
Least common in black ethnicities
Does Kawasaki disease typically affect men or women more?
- women
- 1.3 :1
However in children this is more common in boys
Kawasaki arteritis is a form of medium vessel vasculitis. Which vessels are particularly affected in this condition?
1 - blood vessels of the brain
2 - respiratory blood vessels
3 - coronary blood vessels
4 - renal blood vessels
3 - coronary blood vessels
Kawasaki arteritis is a form of medium vessel vasculitis that predominantly affects the coronary blood vessels. All of the following can be caused EXCEPT which one?
1 - increased risk of coagulation and cardiac ischaemia
2 - weak artery walls due to fibrin deposits increasing aneurysms
3 - thickened blood vessels walls and narrowing lumen inducing a heart attack
4 - valves become dysfunctional due to reduced blood flow
4 - valves become dysfunctional due to reduced blood flow
Patients with Kawasaki arteritis can present with a fever for how long typically?
1 - >24h
2 - >48h
3 - >5 days
4 - >2 weeks
3 - >5 days
Patients with Kawasaki arteritis can cause present in an acute phase with sudden onset, but no specific focus. Changes in the tongue and lips can occur causing which of the following?
1 - ulcers on tongue and lips
2 - strawberry tongue and red cracked lips
3 - dry tongue, mucus membranes and lips
4 - all of the above
2 - strawberry tongue and red cracked lips
Kawasaki disease and scarlet fever both present with a strawberry tongue. Which of the following is a method of distinguishing between Kawasaki disease and Scarlet fever as a cause of the strawberry tongue?
1 - Kawasaki does NOT respond to anti-pyretics
2 - Kawasaki has painless enlarged lymph nodes
3 - Kawasaki rash does NOT blanch
4 - all of the above
4 - all of the above
The opposite of these are all true for Scarlet fever
Patients with Kawasaki arteritis can cause present in an acute phase with sudden onset, but no specific focus. Which of the following typically occur?
1 - inguinal lymphadenopathy
2 - axillary lymphadenopathy
3 - occipital lymphadenopathy
4 - cervical lymphadenopathy
4 - cervical lymphadenopathy
Patients with Kawasaki arteritis can cause present in an acute phase with sudden onset, but no specific focus. Patients with Kawasaki arteritis can develop red lips and a strawberry tongue. Which other body parts can become red and swollen?
1 - face and neck
2 - red palms and soles of feet
3 - torso
4 - upper and lower limbs
2 - red palms and soles of feet
Widespread erythematous maculopapular rash and desquamation
This typically occurs in the sub-acute phase
Although Kawasaki arteritis is self-limiting, meaning it can correct itself, there are a myriad of symptoms and clinical signs. Which of the following is NOT a typical presentation?
1 - aortic dissection
2 - conjunctivitis injection (red eyes)
3 - polymorphic rash affecting most of the body
4 - lymphadenopathy (cervical)
5 - strawberry tongue
6 - swollen hands and feet
7 - fever
8 - carditis/giant coronary aneurysms
1 - aortic dissection
- CRASHS - burn is the mnemonic
Although Kawasaki arteritis is self-limiting, meaning it can correct itself. All of the following can occur and remembered using the mnemonic CRASH. But how many of these are required to confirm a diagnosis?
- bilateral conjunctivitis
- rash
- adenopathy (cervical)
- strawberry tongue
- hands and feet become swollen+red
- fever >5days
1 - all of them
2 - >4 with a fever for 5 days
3 - >3
4 - >2 with a fever for 3 days
2 - >4 with a fever for 5 days
Kawasaki arteritis can cause all of the following except which one?
1 - anaemia
2 - raised WBC
3 - low ESR and CRP
4 - raised LFTs and low albumin
5 - thrombocytosis (raised platelets)
6 - mononuclear white blood cells in the urine without evidence of bacteria
3 - low ESR and CRP
- these are both typically HIGH as there is inflammation
Thrombocytosis (raised platelets) typically signifies the onset of coronary artery aneurysms
Which of the following is most effective for diagnosing Kawasaki disease?
1 - echocardiogram
2 - chest X-ray
3 - clinical diagnosis
4 - biochemistry
3 - clinical diagnosis
A good history and examination
Kawasaki arteritis is typically treated using aspirin and IV immunoglobulins (donor antibodies). Why does the patient need to be monitored very closely during treatment?
1 - reyes syndrome
2 - hypersensitivity reaction
3 - anaphylaxis
4 - heart attack
1 - reyes syndrome
- children taking aspirin are at risk of reyes syndrome
