Miscellaneous

Question 1

What is the pathophysiology of Kawasaki disease?

Answer 1

Autoimmune mediated systemic vasculitis which affects small and medium arteries

Question 2

Clinical features of Kawasaki disease? (there’s a mnemonic)

Answer 2

MYHEART

Mucosal involvement: dry lips, strawberry tongue

Eyes: bilateral conjunctivitis

Adenopathy: cervical, unilateral

Rash: truncal, pleomorphic

Temperature: fever for 5 days

Question 3

Investigations of Kawasaki?

Answer 3

Bloods

Due to concerns about sequelae:
Echo, ECG
Abdominal USS
Urinalysis

Question 4

What blood results would you see in Kawasaki disease?

Answer 4

Thrombocytosis (high platelets)

Raised ESR and CRP

Leukocytosis (raised white cells, esp neutrophils)

Question 5

List some of the sequelae that can occur in Kawasaki disease?

Answer 5

Pericarditis, valve incompetence

Jaundice, hydrops of bladder

Mild anaemia

Aseptic meningitis

Arthritis

Question 6

What is hydrops of bladder?

Answer 6

Distended and full of mucous

Question 7

Within what sort of time frame do cardiovascular sequelae develop in Kawasaki disease?

Answer 7

3 weeks

Question 8

Management of Kawasaki disease?

Answer 8

Admit, due to risk of myocardial events

Aspirin and IV immunoglobulin

Question 9

Why is aspirin not given to children very often?

Answer 9

Risk of Reye’s disease, which is rapidly progressing encephalopathy and liver toxicity

Question 10

How many Kawasaki patients get cardiac sequelae?

Answer 10

50%

Question 11

Presentation of testicular torsion?

Answer 11

Severe pain in the testicle, can radiate to abdomen

So severe it causes vomiting

Red, swollen scrotum

Question 12

If a boy presents with severe testicle pain, what should you think of first?

Answer 12

Testicular torsion until proven otherwise