Rheum

Question 1

HSP- what is it?
4 systems and manifestations involved
Tx

Answer 1

IgA Vasculaitis- leukocytoclastic vasculitits- netutrophils
Palpable purpura
Arthritis at knees and joints
Ab- + Heme in stool, intussception
Kidney- Microscopic hematuria and proteinuira
Tx: NSAIDS/steroids (rare to need steroids)

Question 2

Kawaski

Answer 2

4/5
Fever > 5 days
Lymphadenopathy
Rash
Conjuncivitis
Mucosal involvement
Swelling of hands and feets

Question 3

Kawaski
8 lab values, need at least 3

Answer 3

CRP >3, ESR > 40
WBC >15
Anemia
Platelets > 450
WBC > 10
ALT > 50
Albumim < 3

Question 4

Juevnile Dermatomyositis

Answer 4

Necrosis and inflammation of muscles
Heliotrope rash
Gottron papules

Question 5

Juevnile Dermatomyositis

Answer 5

Necrosis and inflammation of muscles
Heliotrope rash
Gottron papules

Question 6

Lyme Arthritis Mechanism

Answer 6

direct invasion of the synovium, leading to a chronic cytokine-mediated proinflammatory response

Question 7

What sign is bad in Kawaski?

Answer 7

Decreased platelets- risk factor for DIC and coronary artery abnormalities

Question 8

Kawaski treatment

Answer 8

IVIG and aspirin (moderate or high dose)

Question 9

Discharge Kawaski

Answer 9

Afebrile for 36-48 hours

Question 10

SLE vs acute rheumatic fever, specifically arthritis

Answer 10

SLE- Non migratory
ARF- migratory

Question 11

SLE Neuro complications

Answer 11

deliruium psyhosis, seizure, PRES, HTN crisis,

Question 12

Why is SLE more susceptible to encapulated organisms?

Answer 12

Low complemetn, funcationl asplenia

Question 13

SLE vs dermatomysotisis rash

Answer 13

Malar rash in SLE spares nasolabial folds (does not in DM)

Question 14

Labs SLE

Answer 14

+ANA
Specific ones +dsDNA, anti-smith
Low complement
Autoimmune hemolysis
Leukopenia
Thrombocytopenia

Question 15

Oligo vs poly juvenile arthritis

Answer 15

Oligo- toddlers, -Rf, chronic uveitics
Poly- toddlrs and teens, > 5 joints, + Rf or -Rf

Question 16

Systemic JIA

Answer 16

Fever daily
Rash
LAD
Hepatomegaly, splenomegaly
Serositis

Question 17

What suggests a chronic inflammatory arthritis?

Answer 17

Leg length discrepancy

Question 18

In Oligo juevnile arthritis

Answer 18

GEt opthylo

Question 19

Systemic JIA labs

Answer 19

Anemia
Elevated inflammatory markers
Elevated ferritin

Question 20

MAS

Answer 20

Cytokine storm- activation of macrophages
See in systemic JIA
Anemia, low platelets, high ferritin, low fibrinogen
Transaminitis
Tx; STeroids

Question 21

HLH

Answer 21

excessive immune acitvation, cytokine storm
Pancytopenia
Familial, infection (EBV) Cause
Labs: Cytopenias, increase in ferritin, liver dysfunction, seizures, mental status chnge
Tx: SCT, supportive

Question 22

Alpha Thal

Answer 22

< 6 months
Microcytic anemia, splenomegalogy, chronic hemolysis