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Question 1

Two most common vasculitides in children:

Answer 1

Henoch-Schonlein Purpura

Kawasaki disease

Question 2

Henoch-Schonlein Purpura:

Answer 2

• Most common non-thrombocytopenic purpura
• Affects small vessels
• IgA
• Classic Triad: Rash (palpable purpura), Arthritis, Abdominal pain
• Renal involvement is the most important indicator of long term prognosis

Question 3

Kawasaki Disease:

Answer 3

• Affects medium sized blood vessels
• Strawberry tongue, Fever 104 for 5 days, Non-purulent conjunctivitis
• Increased WBC, Sterile pyuria, thrombocytosis
• Loves to attack aorta causing aneurysms (get an EKG)

Question 4

Lyme disease three stages and symptoms in each:

Answer 4

1. ) Early Localized: Erythema migrans
2. ) Early Disseminated: Acute Neurological and Cardiac manifestations (AV Block), Bell’s Palsy, Fatigue
3. ) Late Disease: Arthritis (knee)

Question 5

Manifestations of DGI:

Answer 5

1. ) Triad of Tenosynovitis, Polyarthralgia, Dermatitis without purulent arthritis
2. ) Purulent arthritis without skin lesions

Question 6

DGI Triad symptoms:

Answer 6

• Tenosynovitis is distinct bc it is not in any other infectious arthritis
• Dermatitis is transient
• Synovial Fluid cultures will be Negative
• Blood cultures will be Positive

Question 7

DGI Purulent Arthritis symptoms:

Answer 7

• Knee wrist or ankle
• Afebrile
• Asymmetric

Question 8

SLE key concepts:

Answer 8

• Malar Rash
• Lupus nephritis
• Lupus cerebritis
• Libman-Sacks Endocarditis (Unique bc it is non-bacterial)
• Neonatal SLE-> anti-Ro crosses placenta and causes a congenital heart block (AV block)

Question 9

Sjogren’s Key Concepts:

Answer 9

• SICCA Symptoms -> Dry eyes Dry mouth

- HLA-DR52

Question 10

Sarcoidosis Key Concepts:

Answer 10

• Granulomas -> Multi-nucleated Giant Macrophages
• Ground Glass on X-Ray
• Weight loss, Fatigue, Night sweats

Question 11

Limited Cutaneous Systemic Sclerosis:

Answer 11

-Scleroderma of Hands, Proximal Wrist, Neck, Face
-Vascular Involvement
-CREST Symptoms:
Calcinosis cutis
Raynaud
Esophageal dysphagia
Sclerodactyly
Telangiectasia (mainly in mouth)

Question 12

Diffuse Cutaneous Systemic Sclerosis:

Answer 12

• Scleroderma of Chest, Abdomen, Shoulders/Proximal Arms
• Internal Organ Damage
• Tendon Friction Rub over Forearms and Shins

Question 13

Polymyositis:

Answer 13

• Cell mediated attack on muscle cells

- Proximal Muscle Weakness, Lung disease, Esophageal disease, Cardiac disease

Question 14

Dermatomyositis:

Answer 14

• Same as polymyositis
• Gottron’s Papules -> Dorsum of Hand
• Heliotrope Eruptions -> Upper Eyelids
• Poikiloderma -> Shawl or V sign of skin that is UV sensitize
• High Risk of Malignancies
• Nail abnormalities
• Muscle Weakness with minimal elevation of enzymes

Question 15

PM and DM Treatment:

Answer 15

1st. ) Prednisone
2nd. ) add one of these two
- Azathioprine: preferred for patients with lung disease, liver disease, or ETOH abuse
- Methotrexate: Not safe with ETOH abuse or Liver disease