Rheumatology

Question 1

SLE in children is most closely associated with

Answer 1

glomerulonephritis

Question 2

Kawasaki diagnosis criteria

Answer 2

fever for 4 or more days and 4/5 of the following

1. conjunctivitis
2. cracking of lips/strawbery tongue/ erythema in oral/pharyngeal mucosa
3. cervical lymphadenopathy >1.5 cm, usually unilateral
4. rash
5. erythema/edema of hands and feet in acute phase +/- periungal desquamation

Question 3

Incomplete KD

Answer 3

Infants with fever 7 or more days with no other explanation

OR

Fever 5 or more AND 2 -3 principle criteria who have CRP >3 +/- ESR >40
AND
+ echo findings

OR

3 or more of the following
- Anemia
- Thrombocytosis
- hypoalbuminemia <3
- elevated AST/ALT >50
- WBC
- Non-neutrophilic (sterile) pyuria due to urethritis in KD (>10 WBC/hpf)

Question 4

Diagnostic criteria for JIA

Answer 4

Timing: 6 weeks + arthritis
- worse in the mornings lasting 15 minutes or more, improves with activity
Age: <16
Relieving: activity
Decreased ROM

Question 5

Treatment of JIA

Answer 5

1. NSAID for <2 mo
2. Intraarticular steroid injection
3. DMARD (methotrexate, TNF-a inhibitors like etanercept, anakinra, ritux)

Question 5

Treatment of JIA

Answer 5

1. NSAID for <2 mo
2. Intraarticular steroid injection
3. DMARD (methotrexate, TNF-a inhibitors like etanercept, anakinra, ritux)

Question 6

Dermatomyositis weakness pattern

Answer 6

proximal muscle

Question 7

Treatment of reactive arthritis

Answer 7

Ibuprofen and supportive care

Question 8

Ophtho issue associated with marfan

Answer 8

lens subluxation, glaucoma, cataract

Question 9

Cardiac disease in neonate associated with SLE

Answer 9

3rd degree AV block

Question 10

Pathophysiology of neonatal SLE

Answer 10

transplacental passage of anti-ro/SSA or anti-La/SSB

Question 11

Ferritin cut off for macrophage activation syndrome

Answer 11

> 5000

Question 12

Ferritin cut off for macrophage activation syndrome

Answer 12

> 5000

Question 13

Girl shows up losing hair along part, diagnosis?

Answer 13

linear localized scleroderma
- Red border, white waxy center
- does not need other findings

Question 14

Girl shows up losing hair along part, diagnosis?

Answer 14

linear localized scleroderma
- Red border, white waxy center
- does not need other findings

Question 15

Nodules on skin, non-pruritic, pulm sx and findings, chronic cough, hilar lymphadenopathy. Diagnosis?

Answer 15

sarcoidosis

Question 16

Lab finding for ankylosing spondylitis

Answer 16

HLA-B27 (not needed in adults)