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Pediatrics > Rheumatic And Vasculitic Disorder > Flashcards

Rheumatic And Vasculitic Disorder Flashcards

0
Q

JIA:

Criteria for Diagnosis

A

1-Age onset 2of the following: limited ROM, tenderness, pain on motion, increased heat one or more joints.
3-Duration at least 6 weeks
4-Exclusion of other form of arthritis
5-Onset type by disease presentation in first 6 months .

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1
Q

JIA:

Clinical presentation

A 
1-Morning stiffness 
2-Easy fatigability
3-Joint pain later in day 
4-Joint warm, pain on motion, 
No erythema
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2
Q

JIA

Differential Diagnosis

A 
1-SLE
2-Juvenile dermatamyositis
3-Sarcoidosis /Scleroderma
4-Vasculitis 
5-Autoimmune hepatitis 
6-Late Lyme disease
7-Lymphoproliferative disease
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3
Q

JIA

Category of Disease by Onset ?

A

1-Paucarticular

2-Polyarticular

3-Systemic

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4
Q

Paucarticular ?

A

1-< 5 joints
2-Lower extremity; never hip
3-Larg joints

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5
Q

Polyarticular ?

A

1-_> 5 Joints
2-Larg and small joints
3-Resembles onset in adult
4-Rheumatoid nodules on extensor surfaces of elbow and Achilles’ tendon

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6
Q

Systemic?

A

1-Arthritis and prominent visceral involvement
-Hepatospleenomegaly
-Lymphadenopathy
-Serositis
-Iridocyclitis
2-Daily t٥ spikes at least 39 for 2 weeks
3-Salmon-coloured evanescent rash

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7
Q

JIA

Labs?

A

1-ANA ( younger girls )

2-RF+ ( older girls )

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8
Q

JIA

Management ?

A 
1-NSAID 
2-Methotrexate 
3-Corticosteroid 
       -Overwhelming inflamation 
       -Systemic illness
       -Bridge therapy 
4-Physical therapy / ophthalmology
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9
Q

SLE

Clinical presentation

A

1-Onset > 8years female
2-Fever, fatigue, arthralgia, arthritis, rash
3-Malar rash, discoid, livedo reticularis, Raynaud phenomenon
4-Renal : GN, nephrotic syndrome, renal failure .

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10
Q

SLE

Cardiologic comlication

A
  • Pericarditis
  • Libman-Sacks endocarditis,
  • Cardiomegaly
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11
Q

SLE

Pulmonary complication

A

Pleuritic pain, hemorrhage

Serositis

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12
Q

SLE

Criteria for diagnosis

A 
Requires 4/11
1-Malar rash  2-Discoid rash 
3-Serositis.    4-Oral ulcers
5-ANA+.         6-Photosensitivity
7-Neurologic disorder 
8-Hematologic disorder 
9-Arthritis  
10-Immune disorder( anti-DNA, smith) 
11-Renal disorder
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13
Q

SLE

Lab

A
  • Best screen : ANA
  • Best test : Anti ds-DNA ( Active disease )
  • Anti-Smith Ab: no disease activity
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14
Q

SLE

Management

A 
1-NSAID : for arthritis ( no renal ) 
2-Hydroxychloroquin-mild disease
3-Anticoagluant
4-Corticosteroid : kidney acute 
5-Cyclophosphamide : sever disease
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15
Q

Kawasaki

Definition

A

Acute Vasculitis of medium sized arteries ( coronary)

80% of < 5 years age

16
Q

Kawasaki

Criteria

A 
Fever _>5 days + 4/5 of : 
1-Bilateral nonpurulent conjunctival injection
2-Mucous membrane changes: 
 -Injection pharynx; red dry cracked lips; strawberry tongue
3-Peripheral extremity changes : 
  -Edema/erythema desquamation
4-Rash 
5-Cervical lymphadenopathy >1.5cm
17
Q

Kawasaki

Cardiac findings

A

1-Early-myocarditis in half, tachycardia , decreased ventricular function
2-Pericarditis
3-Coronary artery aneurysm in 2-3 week

18
Q

Kawasaki

Lab

A

1-Platelet high to normal first week , later more than million
2-Normocytic anemia
3-Increased hepatic enzymes
4-CSF pleocytosis

19
Q

Kawasaki

Treatment

A

1-IVIG
2-High dose ASA
3-Steroids ( persistent fever )
4-Warfarin

20
Q

HSP

Definition

A

1-Ig-mediated Vasculitis of small vessels
2-Most common cause of nonthrombocytopenic purpura in children
3-After URI
3-2..8 years
4-Winter
5-Males > females

21
Q

HSP

Clinical

A 
1-Pink maculopapular rash progresses to petechia and purpura over 3-10 days ; under waist
2-Arthritis 
3-GI : abdominal pain , occult blood 
4-Renal 
5-Hepatospleenomegaly

2-

22
Q

Child with limp

A
  • Birth-3years: developmental dysphasia of the hip
  • 4-12 Years: Leg-Calve-Perthes disease ( Idiopathic avascular necrosis of the capital femoral epiphysis )
  • > 12 Years: Slipped Capital Femoral Epiphysis ( ice cream cone)
  • Transient Synovitis : 7-15 days after URI.
23
Q

Intoeing

A

1-Metatarsus adductus
2-Clubfoot ( can’t get heel flat on exam surface )
3-Internal femoral torsion ( _>2 years w sitting ) , surgery if more than 10 years
4-Internal tibial torsion : < 2 years
Resolve by 12 months

24
Q

Torsional deformities

A

1-Genu varum: improve over 1/2 years
2-Genu valgum : overcorrection
3-Leg length discrepancy: > 2 cm require surgery

25
Q

Knee Problems

A

1-Popliteal cyst: resolve by 10 years
, if not then surgery .
2-Oshood-Schaltter disease : overuse injury traction apophysitis
( rest ) resolve 12-24 months

26
Q

Osteomyelitis

Etiology

A

1-S.aureus
2-Neonate: GBS and gram -
3-Pseudomonas-puncture wound
4-Salmonella -Sickle cell

27
Q

Septic Arthritis

Etiology

A

S.aureus

28
Q

Osteomyelitis

Best test

A

MRI

29
Q

Osteogenesis imperfecta

Clinical triad

A

1-Fragile bone
2-Blue sclera
3-Early deafness

Pediatrics (6 decks)

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