Rheumatic Diseases

Question 1

What type of inflammation is seen in juvenile idiopathic arthritis?

Inflammation of synovium

Answer 1

Non-suppurative

Question 2

S/Sx of Juvenile idiopathic Arthritis.

Answer 2

• Fever
• Rheumatic rash
• Hepatosplenomegaly
• Lymphadenopathy

Question 3

What joints are usually spared in polyarticular juvenile idiopathic arthritis?

Answer 3

Lumbasacral

Question 4

Which gender is more affected by polyarticular juvenile idiopathic arthritis?

Answer 4

Female

Question 5

At what age does polyarticular juvenile idiopathic arthritis typically arise?

Answer 5

> 8 yo

Question 6

What joints are typically affected by polyarticular juvenile idiopathic arthritis?

Answer 6

Larger joints

Question 7

Type II polyarticular juvenile idiopathic arthritis is associated with what HLA marker?

Answer 7

HLA-DR4

Question 8

What laboratory data leads to the Dx of pauciarticular JIA?

Answer 8

• Anemia
• Leukamoid reactions
• Increased platelets
• cloudy synovial fluid w/ increased protein
• Soft tissue swelling (on XR)

Question 9

SE of ASA Tx in Pauciarticular JIA.

Answer 9

• Hyperventilation
• Drowsiness
• Tinnitus
• Reyes syndrome

Question 10

What type of onset of JIA displays large joint involvement symmetrically?

Answer 10

Pauciarticular JIA

Question 11

What is the most common type of Pauciarticular JIA?

Answer 11

Type I

HLA-DR5, HLA-DR6, HLA-DR8, ANA

Question 12

50% of children with pauciarticular JIA will display what type of involvement?

Answer 12

Eye; iridocyclitis (anterior chamber of eye)

Question 13

Unlike polyarticular JIA, pauciarticular JIA displays involvement in which joints?

Answer 13

Lumbosacral

Question 14

What are the HLA and ANA factors of Type I Pauciarticular JIA?

Answer 14

• HLA-DR5
• HLA-DR6
• HLA-DR8
• Increased ANA

Question 15

What are the HLA & ANA factors of Type II Pauciarticular JIA?

Answer 15

• HLA-B27
• No increase in ANA

Question 16

Reyes syndrome can be caused by the administration of what medication to a pediatric patient?

Answer 16

Aspirin

Question 17

The rash will be from the waist down in which disease?

Answer 17

Henoch-Schonlein Purpura

Question 18

In Henoch-Schonlein Purpura, a patient will display what type of purpura?

Answer 18

• Nonthrombocytopenic purpura
• Rash from waist down

Question 19

Why does muscle inflammation occur in calcinosis?

Answer 19

Ca2+ deposits within muscle tissue

Question 20

What type of patches are noted with calcinosis (dermatomyositis)?

Answer 20

Guttron patches (red, scaly patches on elbows, knee, and knuckles)

Question 21

The rash in dermatomyositis involves what folds?

Answer 21

Nasolabial folds

Question 22

What clinical feature is noted symmetrically in calcinosis (dermatomyositis)?

Answer 22

Symmetric weakness of proximal muscles (e.g., hips & legs)

Question 23

What factor is positive in most pediatric patients with SLE?

Answer 23

ANA

Question 24

What are the clinical features of SLE in pediatric patients?

Answer 24

• Ulcers in mouth
• Malar rash (nasolabial folds are spared)
• Scarring alopecia
• Cutaneous vasculitis

Question 25

What is the Triphasic course of Kawasaki disease?

Answer 25

• Acute: fever, nonpurulent conjunctivitis, rash, orpharyngeal edema
• Subacute: peeling of hands & feet
• Convalescent: cracked lips & strawberry tongue

Question 26

A fever of >5 days may indicate what disease?

Answer 26

Kawasaki disease

Question 27

What are the (5) diagnostic features of Kawasaki Syndrome?

4/5 must be present for Dx

Answer 27

• Bilateral conjunctivitis
• Strawberry tongue
• Changes in peripheral extremities
• Rash (Non-vesicular)
• Cervical lymphadenopathy