Lesson 1: Kawasaki Disease Flashcards
Kawasaki Disease (DK), formerly know as _____________ on children especially younger than_______.
Kawasaki Disease (DK), formerly know as mucocutaneous lymph node syndrome on children especially younger than 5 years.
KD is a ______ with a predilection for the _________.
KD is a vasculitis with a predilection for the coronary arteries.
____________% untreated patients have coronary abnormalities , including aneurism.
20%-25% untreated patients have coronary abnormalities , including aneurism
KD is the leading cause of ___________ in children in most developed countries ,including USA and Japan.
KD is the leading cause of acquired heart disease in children in most developed countries ,including USA and Japan.
Etiology
- ________
Etiology
- Unknownetiology
KD is a Vasculitis that predominantly affect the _________ , with a striking predilection for the _________.
KD is a Vasculitis that predominantly affect the medium size arteries , with a striking predilection for the coronary arteries.
______ of endothelial and smooth muscle cell with intense inflammatory infiltration of the vascular
Edema of endothelial and smooth muscle cell with intense inflammatory infiltration of the vascular
In the most severely affect vessels, involve _________ of the vascular wall
In the most severely affect vessels involve all 3 layers of the vascular wall
The destruction of the _____________ result dilation(Ectasia)or saccular fusion aneurysm formation
The destruction of the internal elastic lamina result dilation(Ectasia)or saccular fusion aneurysm formation
________may form in the lumen and obstruction blood flow
Thrombi may form in the lumen and obstruction blood flow
Overtime the vascular wall can become ______ with marked intimal proliferation , producing arterial stenosis or occlusion
Overtime the vascular wall can become fibrotic with marked intimal proliferation , producing arterial stenosis or occlusion
Clinical manifestation
High fever temperature 39-40C and unresponsive with __________.
Clinical manifestation
High fever temperature 39-40C and unresponsive with antibiotic
Duration without treatment is generally ________ weeks but may persist for __________ weeks.
Duration without treatment is generally 1-2 weeks but may persist for 3-4 weeks.
Inadditionoffeverneedmorefiveprincipalcriteria:(CRASH)
- __________withlimbalsparing
- ____ofvariousformwithaccentuationinthegroinarea.
- Nonsuppurative__________usuallyunilateral.
- Erythemaoftheoralandpharyngealmucosawith________anddrycreakedlips.
- Edemaanderythemaofthe_______and_______.
Inadditionoffeverneedmorefiveprincipalcriteria:(CRASH)
- Conjunctivalinjectionwithlimbalsparing
- Rashofvariousformwithaccentuationinthegroinarea.
- NonsuppurativecervicallymphAdenopathyusuallyunilateral.
- Erythemaoftheoralandpharyngealmucosawithstrawberrytongueanddrycreakedlips.
- Edemaanderythemaofthehandsandfeet.
Associated symptoms other than the clinical criteria are common in the _____days prior to diagnosis of KD.
Associated symptoms other than the clinical criteria are common in the 10 day prior to diagnosis of KD.
Gastrointestinal symptoms(vomiting diarrhea , or abdominal pain) occur in almost _________%.
Gastrointestinal symptoms(vomiting diarrhea , or abdominal pain) occur in almost 65%.
Respiratory symptoms (interstitial infiltrates ,effusion) occur in ____________.
Respiratory symptoms (interstitial infiltrates ,effusion) occur in 30%.
_______ involvement is the most important manifestation of KD
Cardiac involvement is the most important manifestation of KD
_______ occur in most patients with acute KD and manifests as tachycardia __________ to fever along with diminish left ventricular systolic function.
Myocarditis occur in most patients with acute KD and manifests as tachycardia out of proportion to fever along with diminish left ventricular systolic function.
_________ with a small pericardial effusion can also occur during in the acute illness
Pericarditis with a small pericardial effusion can also occur during in the acute illness
Coronary artery aneurysm develop up to ________% of untreated patients in the second to third weeks of illness.
Coronary artery aneurysm develop up to 25% of untreated patients in the second to third weeks of illness.
In the absence of treatment, KD can be divided into 3 clinical phase:
- ______
- _________
- _______
In the absence of treatment, KD can be divided into 3 clinical phase:
- The acute febrile phase
- The sub acute phase
- The convalescence phase
The acute febrile phase: is characterized by _____ and the other acute signs of illness and usually last _____ weeks.
The acute febrile phase: is characterized by fever and the other acute signs of illness and usually last 1-2 weeks.
The sub acute phase: is associated with ______ , _______ , the developments of coronary _____ and highest risk of ______and last about ______weeks.
The sub acute phase: is associated with desquamation , thrombocytosis , the developments of coronary aneurism and highest risk of sudden death and last about 2 weeks.
The convalescence phase: began when all clinical signs of illness _____ and continue until the __________return to normal typically about ______ weeks after the onset of illness.
The convalescence phase: began when all clinical signs of illness disappeared and continue until the erythrocyte sedimentation rate return to normal typically about 6-8 weeks after the onset of illness.
Diagnosis
Based on ________
Diagnosis
Based on clinical diagnosis
The classic KD the diagnosis require the presence of ________ for at least_____days and at least ______ of five the other principal characteristic of the illness.
The classic KD the diagnosis require the presence of fever for at least 4 days and at least four of five the other principal characteristic of the illness.
In atypical or incomplete KD, fever with ________of the five characteristic .In these patient ,laboratory and echocardiography can assist the diagnosis.
In atypical or incomplete KD, fever with less than four of the five characteristic .In these patient ,laboratory and echocardiography can assist the diagnosis.
Differential diagnosis: \_\_\_\_\_\_infections \_\_\_\_\_\_\_\_\_infection \_\_\_\_\_\_\_\_\_ disease Other - \_\_\_\_\_\_\_syndrome - St\_\_\_\_\_\_\_\_\_\_\_\_\_skinsyndrome. - \_\_\_\_\_\_\_\_\_\_reactions. -S\_\_\_\_\_\_\_\_syndrome.
Differential diagnosis: Viral infections Bacterial infection Rheumatology disease Other - Toxicshocksyndrome - Staphylococcalscaldedskinsyndrome. - Drughypersensitivityreactions. -Steven–johnsonsyndrome.