Rheum And Immune

Question 1

10 warning signs of primary immunodeficiencies

Answer 1

4 new ear infections
2 serious sinus infections
2 months on Abx with little improvement
Ftt
Recurrent abscess
2 pneumonias
Persistent fungal infections
Requiring iv Abx
2 septic like infections
Family hx

Question 2

JIA

Answer 2

Persistent arthritis for >6 weeks in a child younger than 16
No other cause for arthritis
7 types

Question 3

JIA management

Answer 3

OT/PT
NSAIDS
corticosteroids 
DMARDS (disease modifying anti rheumatic drugs)
T and B cell therapy

Question 4

Complications of JIA

Answer 4

Uveitis (could lead to blindness)
Poor linear growth
Growth abnormalities

Question 5

Symptoms in SLE

Answer 5

Malar Rash
Photosensitivity 
Arthritis
Nephritis
Encephalopathy 
Pleurisies or pericarditis 
Cytopenia

Question 6

Classic Kawasaki symptoms

Answer 6

Need at least 4
Bilateral painless bulbar conjunctiva injection (red eye)
Lips and oral cavity may be dry or cracked and very red- strawberry tongue
Polymorphous exanthem- trunk rash
Cervical lymphadenopathy
Changes in extremities or peri area- erythema and edema to palms and soles then starting to peel

Question 7

Kawasaki lab findings

Answer 7

CBC- leukocytosis and increased neutrophils
Elevated ESR CRP platelets transaminases and ggt
Hypoalbiminemia
Anemia

Question 8

Major cardiac complication from Kawasaki

Answer 8

Coronary artery aneurism

Myocarditis

Question 9

Kawasaki management

Answer 9

IVIG 2g/kg

Aspirin 80-100 mg/kg weaned after devervesense May need life long if cardiac issues present

Question 10

Management of anaphylaxis

Answer 10

ABC
D/c exposure
Epi IM 1:1000 0.1 mg/kg
Fluid bolus if hypotension