Lec 22 Pediatric Rheumatology

Question 1

What are the 3 subtypes of juvenile chronic arthritis?

Answer 1

• systemic
• polyarticular
• pauciarticular

Question 2

What type of JRA has best vs worst prognosis for joints?

Answer 2

best = systemic or pauciarticular
worse = polyarticular RF+ girls

Question 3

What type of JRA has worst prognosis for life?

Answer 3

worst = systemic

Question 4

What are symptoms of systemic JRA?

Answer 4

arthritis, fever, rash, serositis, organomegaly, leukocytosis

Question 5

What are symptoms of polyartricular JRA?

Answer 5

fever, anemia, malaise

Question 6

What are symptoms of pauciarticular JRA?

Answer 6

have iriocyclitis –> uveitis/iritis

Question 7

What are signs of adult still’s disease?

Answer 7

arhtralgias/arthritis
maculopapular rash --> salmon colored rash on trunk only present in height of fever
spiking fevers
seronegative
lymphadenopathy

Question 8

What is treatment for JIA?

Answer 8

methotrexate

Question 9

What is macrophage activation syndrome?

Answer 9

life threatening complication of still/systemic JIA

have immune activation of T cells and macrophages –> pancytopenia; hyperferritinemia

Question 10

What happens in stage 1 lyme disease?

Answer 10

erythema migrans

flu like syndrome

Question 11

What happens in stage 2 lyme disease?

Answer 11

early disseminated –> recurrent erythema migrans; migratory arthritis; meningoencephalitis; bell’s palsy; carditis

Question 12

What is treatment for lyme disease?

Answer 12

doxycycline early in disease

amoxicillin in kids

Question 13

What are most common organisms in septic arthritis in adults?

Answer 13

staph aureus; strep; neisseria gonorrhoae/meningitidis

Question 14

What are most common organisms in septic arthritis in kids?

Answer 14

staph aures, strep pyogenes, H influenza

Question 15

Who gets gram negative septic arthritis?

Answer 15

IV drug users

Question 16

What is kawasaki clinical picture?

Answer 16

• spiking fever for at least 5 days
• bilateral conjunctival congestion
• oropharynx invovlement
  strawberry tongue

Question 17

How do you treat kawasaki?

Answer 17

IV Ig

Question 18

What do you see in neonatal lupus?

Answer 18

rash on face and upper trunk –> from Rh+ kid with Rh- baby –> get skin disease that goes away in 3-4 months

Question 19

What are clinical feat of myositis?

Answer 19

proximal muscle weakness
dysphagia
high muscle enzymes

Question 20

What antibodies seen in myositis?

Answer 20

• anti-synthetase syndrome –> Ab against aminoacyl-tRNA synthetases
• anti Jo-1