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Peds > Peds Rheum > Flashcards

Peds Rheum Flashcards

1
Q

What is the MC of childhood arthritis

A

Juvenile idiopathic/rheumatoid arthritis

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2
Q

What is the diagnostic crieteria for JIA

A

6 wks and fever > 2 weeks, Morning stiffness

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3
Q

Definition of arthritis

A

Limited ROM, tenderness, pain on motion or joint warmth – need 2

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4
Q

What is the DDX of JIA

A

postinfectious arthritis, trauma, septic arthritis, childhood malignancies

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5
Q

What are the subtypes of JIA

A

systemic, polyarticular, pauciarticular

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6
Q

What is the peak age for onset of systemic JIA

A

1-6 yo

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7
Q

What is a rare but poor prognostic factor of systemic JIA

A

uveitis

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8
Q

presentation of systemic JIA

A

daily or 2xd fever spikes >101F, nonpruritic maculopapule rash, intermittent sx, fatigue, irritability, myalgia, general lymphadenopathy, HSM

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9
Q

Lab findings of systemic JIA

A

ESR > 100, elevated ferritin, platelet counts increased, ANA and RF negative

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10
Q

Complications of systemic JIA

A

pericardial tamponade, severe vasculitis with coagulopathy, macrophage activation syndrome

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11
Q

What gender is more likely to develop polyarticular JIA

A

female

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12
Q

presentation of RF + polyarticular JIA

A

girls > 8 yo, HLA-DR4+, 50% ANA +, 5% uveitis

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13
Q

How often will a RF+ polyarticular JIA patient get a slit lamp exam

A

6 mos

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14
Q

presentation of RF - polyarticular JIA

A

younger, nodules, low grade fever, 25% ANA +

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15
Q

what percent of RF- polyarticular JIA patients develop into erosive arthritis

A

15%

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16
Q

General presentation of pauciarticular JIA

A

_4 joints, absent systemic signs, RF -, large joints more often affected

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17
Q

What is the most common joint affected in pauciarticular JIA

A

knee

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18
Q

presentation of early onset pauciarticular JIA

A

1-5 yo, females, ANA+, eye inflammation, anterior chamber inflammation, severe eye disease if not treated

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19
Q

Late onset presentation of pauciarticular JIA

A

boys, HLAB27+, enthesitis or tendonitis, large joints and spine affected, eye complications are RARE

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20
Q

treatment of JIA

A

NSAIDs first line but may take a month to get affect, H2 blocker may be necessary, methotrexate if NSAIDs not enough

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21
Q

How long does methtrexate take to be active in JIA

A

3-4 weeks for initial response, 3-6 mos for max response

22
Q

what other immunosuppressive meds are used in tx of JIA

A

sulfasalazine

23
Q

What med is reserved for severe complications of JIA

A

corticosteroids

24
Q

what is the mc of childhood vasculitis

A

henoch-schonlein purpura

25
Q

what gender is more commonly affected by henoch-schonlein purpura

A

males

26
Q

what other organ systems are involved in henoch schonlein purpura

A

GI and Kidney

27
Q

what is the most common precipitating factor of HSP

A

URI

28
Q

what immunoglobulin is thought to be involved in HSP

A

IgA

29
Q

What is the tetrad of HSP

A

palpable purpura, arthritis, abdominal pain, glomerulonephritis

30
Q

How long does the rash last in HSP

A

3 weeks

31
Q

What are GI complications that occur with HSP

A

ileocolic intussusception, pancreatitis, infarction, perforation, hydrops of the gallbladder

32
Q

What is the treatment of HSP

A

NSAIDs, self limited

33
Q

What arteries are mainly affected with Kawasaki Disease

A

coronary arteries

34
Q

What cells are elevated in Kawasaki Disease

A

T cells, B cells, monocytes and macrophage

35
Q

Presentation of Kawasaki Disease

A

first high fever (100-104 F), then rash, conjuctival injectin, oral mucosal changes

36
Q

How long will the fever last in Kawasaki Disease

A

5 days or more

37
Q

what are the mucous membrane changes in Kawasaki Disease

A

Diffuse injection or oral and pharyngeal mucosa, erythema or fissuring of lips and anus, strawberry tongue

38
Q

When will an aneurysm appear in Kawasaki Disease

A

boys, children

39
Q

What are the CNS manifestations of Kawasaki Disease

A

Aseptic meningitis, facial palsy, subdural effusion, cerebral infarction

40
Q

Treatment of Kawasaki Disease

A

flu shot, ASA, IVIG to reduce aneurysms, fever and inflammation

41
Q

What are the possible triggers of SLE

A

Genetics, Hormones, Environment, illness

42
Q

What is the criteria of SLE

A

Malar rash, oral ulcers, photosensitivity, arthritis, glomerulonephritis, thrombocytopenia, anti-DNA or Anti-Sm antibodies

43
Q

What test is used to evaluate SLE

A

anti-DNA and complement levels

44
Q

What test show an increased risk of thrombosis of SLE

A

antiphospholipid antibodies and lupus anticoagulant

45
Q

Treatment of SLE

A

Plaquenil, glucocorticoids, immunosuppresives

46
Q

What is the pathogen that causes Lyme Disease

A

Borrelia Burgdorferi

47
Q

What age group is Lyme Disease the most common

A

5-10 years

48
Q

What is the most common presentation of Lyme Disease

A

Erythema migrans within 1 month of infection

49
Q

What are the most common manifestations of early disseminated Lyme disease

A

cardiac and neurological disease

50
Q

What is the oral treatment for Lyme Disease

A

Doxy if >7 yo or Amoxicillin

51
Q

What is the IV therapy for Lyme Disease

A

Ceftriaxone or Cefotaxime

Peds (16 decks)

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