Peds - Rhuem

Question 1

How long does a child need sx of arthritis for dx of JIA?

Answer 1

6 weeks

Question 2

Labs for JIA

Answer 2

Think inflammation -
CBC, ESR, SRP, serum protein
ANA, Rheumatoid factor

Question 3

In kids w/ JIA - Rheumatoid factor + or -?

Answer 3

negative!

+ for adolescents, adults with RA

Question 4

What’s for w/ ANA for JIA detection?

Answer 4

20% false +

Question 5

Would you expect joint fluid analysis to be + for JIA?

Answer 5

No, this would be indicative of osteomyelitis etc

Question 6

MCC treatable blindness kids?

Answer 6

uveitis 2nd to JIA (asymptomatic)

Question 7

heliotrope rash, Gottron’s papules, periungual erythema associated w/ ?

Answer 7

Juv Dermomyositis

+ hip/shoulder girdle, abd, neck weakness

Question 8

Labs for JDM

Answer 8

muscle enzyme, muscle bx, MRI

Question 9

MCC systemic vasculitis kids?

Answer 9

Henoch Schonlein Purpura

Question 10

Palpable purpura buttocks W/O thrombocytopenia

Answer 10

HSP

Question 11

arthritis w/ non-erythematous swelling + peripheral/scrotal edema

Answer 11

HSP

Question 12

Complications HSP

Answer 12

colicky abd pain, glomerulonephritis

Question 13

HSP labs

Answer 13

^ esr, crp, wbc
normo- chromic/cytic anemia
+/- ^BUN

Question 14

HSP histo finding

Answer 14

leukocytoclastic vascultis w/ IgA deposition

Question 15

EULAR criteria

Answer 15

non-thrombo purpura + any of below

• arthralgia
• abd pain/GI blood
• bx w/ IgA

Question 16

Kawasaki - what age ?

Answer 16

6mo-5 yo (90%)

Question 17

List 6 sx of Kawasaki + 7 late stage complication

Answer 17

• fever 5+ days
• b/l conjuntivitis (no exudate)
• full body rash
• single cervical node 1.5+ cm
• cracked lips + strawberry tongue
• swollen feet/hands
• late: CA aneurysm
• if they have 4 of the following can be dx w/ fever @ 4d

Question 18

age for growing pains

Answer 18

3-7 yo

Question 19

Red flags for malignancy (5)

Answer 19

non-articular bone pain
back pain
bone tenderness
night sweats/sev constitutional sx 
bruising

Question 20

Galazzi sign

Answer 20

DDH: baby on back w/ knees bent and ankles touching butt. if knees not level, it’s positive.

Question 21

Pavlik harness - up til what age

Answer 21

6 mo

Question 22

Barlow manuever

Answer 22

ADDUCTS hips (will dislocate if unstable)

Question 23

Ortlani manuever

Answer 23

ABDUCTS hips (will pop back into place if dislocated by the Barlow)

Question 24

Atraumatic painless limp w/ decr. internal rotation + ABDuction

Answer 24

avascular necrosis of femoral head

Question 25

Hip/knee pain + diff. walking + leg held in external rotation (limited internal rotation)

Answer 25

Slipped capital femoral epiphysis

Question 26

MCC in-toeing >2yo

Answer 26

internal FEMORAL torsion/anteversion

prefer w-sitting

Question 27

MCC in-toeing <2 yo

Answer 27

internal TIBIAL torsion

Question 28

MCC out-toeing

Answer 28

external tibial/femoral torsion

Question 29

flatfoot - in or out toeing

Answer 29

out

Question 30

torticollis

Answer 30

ear to clavicle on affected side

Question 31

genu varum vs vagum

Answer 31

varum (bow)

vagum (knock knee)

Question 32

AA - where polydactyly?

Answer 32

little finger MC, and isolated (not part of another d/o)

Question 33

type 2 polydactyly

Answer 33

finger w/ bones+joint but NO metacarpal

Question 34

non-idiopathic scoliosis

Answer 34

CP, muscular dystrophy, MSK d/o

Question 35

who gets screen for scoliosis

Answer 35

F @ age 10 + 12

M @ age 13 or 14

Question 36

How does child hold arm in Nursemaids elbow?

Answer 36

close to body, pronated, avoids using it