Lecture 14 fun sized RA (Juvenile RA)

Question 1

Juvenile Rheumatoid Arthritis (JRA) is _____ in onset and occurs in children less than ____ years of age

Answer 1

idiopathic;

16

Question 2

3 different forms of JRA:

Answer 2

pauciarticular, polyarticular, systemic

Question 3

nonspecific clinical features of JRA include _____, posturing to protect the joint, and refusal to _____

Answer 3

irritability; walk

Question 4

Polyarticular JRA requires involvement of ___ or more joints. The pattern of involvement is typically ____, as in adult RA

Answer 4

5, symmetrical

Question 5

arthritis of apophyseal joints of the ___ is common in JRA. This can lead to neck ___ and loss of range of motion

Answer 5

spine, stiffness

Question 6

____ involvement can occur with limitation of the bate and recession of the chin (_____)

Answer 6

TMJ; micrognathia

Question 7

Systemic manifestations are _____ in patients with polyarticular JRA

Answer 7

mild

Question 8

Oligarticular/pauciarticular JRA involves less than ____ joints. Half of these are typically ______

Answer 8

5; monoarticular

Question 9

Type 1 pauciarticular features:
primarily \_\_\_\_\_ gender;
\_\_\_\_ childhood;
\_\_\_\_\_ positive; 
classic symptom:
long term risk of \_\_\_\_\_

Answer 9

female;
early;
ANA;
uveiits;
polyarticular disease

Question 10

Type 2 pauciarticular features:
primarily \_\_\_\_ gender;
\_\_\_\_ childhood onset;
\_\_\_\_ positive;
classic symptoms: peripheral arthritis \_\_\_\_, axial \_\_\_\_\_, also \_\_\_\_\_
long term risk of \_\_\_\_\_\_

Answer 10

male;
late;
HLAB27l
early, late, enthesitis;
anylosing spondylitis

Question 11

2 extremely common features of systemic onset JRA:

Answer 11

rash and fever

Question 12

The fever typically occurs ____. there are chills but not _____

Answer 12

daily (quotidian); rigor

Question 13

The rash in systemic JRA is said to be ____, aka of short duration at one location that tends to be migratory

Answer 13

evanescent

Question 14

Systemic JRA often has koebner phenomena, which is _____

Answer 14

rash that is induced by scratching

Question 15

visceral lesions are _____ with systemic JRA

Answer 15

common

Question 16

heart involvement of systemic JRA: ____

eye involvement: _____ and ____ iritis; inflamed anterior uvea causes ____

Answer 16

pericarditis;
uveitis, white; iridocyclitis

also hepatosplenomegaly, adenopathy

Question 17

_____ retardation is also seen in systemic JRA. _____ (Short fingers) can occur due to premature closure of the growth plate

Answer 17

growth; brachydactylyl

Question 18

Children are much less frequently positive for _____ than adults with RA

Answer 18

rheumatoid factor

Question 19

ANA positivity is highest in patients with _____ JRA

Answer 19

pauciarticular

Question 20

what is often very high on the CBC in JRA?

Answer 20

leukocytosis

Question 21

On X-ray, soft tissue _____ and periarticular ____ is often seen

Answer 21

swelling, demineralization

Question 22

_____ ____ is a characteristic change of the cervical spine

Answer 22

atlantoaxial sublaxation

Question 23

_____ are the basis of treatment. ____ are usually injected intra-articularly

Answer 23

NSAIDS; cortiocsteroids

Question 24

In patients not responding to NSAIDS, ____ is typically used

Answer 24

methotrexate

Question 25

Patients with the ____ type have the worst prognosis

Answer 25

systemic onset