Rheumatology Flashcards
[Rhem/JIA]
Juvenile idiopathic arthritis definition?
- Occurring before < __ years of age
- _ in ≥ 1 joints
- _ for ≥ 6 weeks
- Occurring before < 16 years of age
- Persistent synovitis in ≥ 1 joints
- Synovitis for ≥ 6 weeks
[Rhem/JIA]
Which type of Juvenile idiopathic arthritis and usual ANA finding?
Between 1 and 5 years old, M=F
Daily high fever ≥ 102.2F for ≥ 2 weeks, resolves without antipyretics (quotidian fever), usually in the evening
Salmon colored rash, appeared by mild rubbing (Koebner phenomenon)
Arthritis (usually polyarticular)
Pericarditis, myocarditis, pleuritis, lymphadenopathy, hepatosplenomegaly, abdominal pain
Leukemoid reaction (WBC > 40K), thrombocytosis (> 1 mil)
Systemic JIA
ANA: Negative
[Rhem/JIA/Cx]
Which disease? (Complications from sJIA)
Persistent fever
Hepatosplenomegaly
Markedly high ferritin
Cytopenias
Liver dysfunction
Neurologic dysfunction
Macrophage activation syndrome
[Rhem/JIA]
Which type of Juvenile idiopathic arthritis?
Joints ≤ 4 in the first 6 months of disease
Between 1 and 3 years old, F>M
Asymptomatic anterior uveitis
Non-specific laboratory findings (+/- ANA, +/- Inflammatory markers)
Oligoarticular JIA
[Rhem/JIA]
Which type of Juvenile idiopathic arthritis?
Joints ≥ 5 in the first 6 months
Between 1-3 and 9-14, F>M
ANA (+)
Rheumatoid factor (-)
Less aggressive symptoms
RF Negative polyarticular JIA
[Rhem/JIA]
Which type of Juvenile idiopathic arthritis?
Joints ≥ 5 in the first 6 months
Teenage, F>M
ANA (-)
Rheumatoid factor (+)
Anti-CCP ab (+)
RF Positive polyarticular JIA
[Rhem/JIA]
Which type of Juvenile idiopathic arthritis?
Arthritis (DIP joint)
Psoriasis or Familial history of psoriasis
Dactylitis
Nail finding: pitting, onycholysis
HLA-B27 (adolescent with back pain)
Juvenile psoriatic arthritis
[Rhem/JIA]
Which type of Juvenile idiopathic arthritis?
Teenage male
Arthritis
Enthesitis, Sacroiliac joint tenderness
Asymptomatic uveitis or irititis
Acute symptomatic uveitis
HLA-B27 (+), ANA (-), ESR normal
Enthesitis-related arthropathies
[Rhem/JIA/Tx]
Treatment options for JIA (3)?
- NSAIDs (initial treatment)
- DMARDs - Methotrexate (with folate)
- Joint steroid injections (2nd line)
[Rhem/JIA/Tx]
Side effect of methotrexate (usual treatment for JIA) (3)?
- Liver abnormalities
- Oral ulcers
- Cytopenias
[Rhem/Arthritis with IBD]
Characteristics of Peripheral arthritis associated Inflammatory Bowel Disease
- Incidence F _ M
- HLA-B27 association: _
- Arthritis flares with gut flares: _
Peripheral arthritis
- Incidence F = M
- HLA-B27 association: no
- Arthritis flares with gut flares: yes
[Rhem/Arthritis with IBD]
Characteristics of Axial arthritis associated Inflammatory Bowel Disease
- Incidence F _ M
- HLA-B27 association: _
- Arthritis flares with gut flares: _
Axial arthritis
- Incidence F < M
- HLA-B27 association: yes
- Arthritis flares with gut flares: no
[Rhem/Arthritis]
Which arthritis and treatment?
1-4 weeks after GI or GU infection
Sterile pyuria, dysuria (urethritis)
Conjunctivitis
Arthritis, enthesitis, dactylitis
Oral, genital ulcers, balanitis
Keratoderma blenorrhagicum (papular skin lesions)
HLA-B27 (+), ANA (-), RF (-)
Reactive arthritis
(can’t pee, can’t see, can’t bend knee)
- Treatment:
NSAIDs for 2-4 weeks
[Rhem/Vasc/Sm]
Examples of small vessel vasculitis? (4)
- Drug reations
- Serum sickness
- IgA vasculitis (HSP)
- Granulomatosis with polyangitis (GPA)
[Rhem/Vasc/Med]
Examples of Medium vessel vasculitis? (2)
- Polyarteritis nodosa (PAN)
- Kawasaki disease (KD)