Rheumatology

Question 1

Classification of JIA

Answer 1

Question 2

Jones Criteria for ARF

Answer 2

In the context of a previous strep infection

Question 3

Kocher Criteria

Answer 3

Question 4

Features of Lyme Disease

Answer 4

Question 5

Diagnosis and treatment of Lyme Disease

Answer 5

Treat for 2-4 weeks, or at minimum until the rash is gone

Question 6

Answer 6

Erythema Marginatum - Acute Rheumatic Fever

Question 7

Leg length discrepancy in JIA

Answer 7

affected leg will be longer because growth plate doesn’t close on time increased blood flow to the growth plate!

Question 8

Complications of Uveitis

Answer 8

• Synechiae (irregular pupil)
• Cataracts
• Glaucoma
• Vision loss

*Does not parallel the arthritis course
Higher risk in: female, ANA +ve, age < 6, oligo
Asymptomatic except in enthesitis related arthritis

Question 9

Complications of JIA

Answer 9

• leg length discrepancy
• uveitis
• muscle wasting
• tmJ disease
• flexion contracture
• growth discrepancies

Question 10

Side effects of joint injections

Answer 10

• infection
• tightening of skin?

Question 11

Treatment of Oligo-JIA

Answer 11

Question 12

Treatment of Poly-JIA

Answer 12

Question 13

Treatment of systemic JIA

Answer 13

Question 14

What 3 conditions predispose to MAS?

Answer 14

Kawasaki
Systemic JIA
Lupus

Question 15

Side Effects of MTX

Answer 15

Ulcers improved by folic acid!

Question 16

Side effects of Anti-TNF inhibitors

Answer 16

Malignancy black box warning - has been reported!

Question 17

SLE criteria

Answer 17

**Outcome and therapy dependent on kidney disease

Question 18

Monitoring SLE

Answer 18

• ESR correlates with disease activity
• CRP elevated in infection, serositis or MAS

Question 19

Treatment of SLE

Answer 19

Mild:
- NSAIDS
- Plaquenil (retinal toxicity and colour blindness)
- low dose prednisone

Severe:
- High dose steroids
- Cyclophosphamide/rituximab - immunosuppression

Question 20

Drug-Induced Lupus

Answer 20

Question 21

Neonatal Lupus

Answer 21

anti-Ro
anti-La
Liver, cardiac (irreversible), skin rash (annular, central clearing, photosensitivity), CNS abnormalities, cytopenias

Question 22

JDM Criteria

Answer 22

EMG/MRI for diagnosis (proximal muscle inflammation)
- technically gold standard = muscle biopsy

Question 23

Answer 23

Calcinosis - JDM (treatment is treating the disease!)

Question 24

JDM Clinical Features

Answer 24

Question 25

Treatment of JDM

Answer 25

Question 26

Answer 26

HSP

Question 27

Tetrad of HSP

Answer 27

• purpuric rash on lower limbs/buttocks
• arthritis
• abdominal pain
• renal disease (can come later)

Question 28

Clinical Features of HSP

Answer 28

Question 29

Treatment of HSP

Answer 29

Question 30

Risk Factors for aneurysms in KD

Answer 30

Question 31

Periodic Fever Syndromes

Answer 31

Question 32

PFAPA

Answer 32

Question 33

Answer 33

Erysipeloid Erythema - FMF

Question 34

FMF

Answer 34

Complication: Amyloidosis
Treatment: Colchicine

Question 35

Side Effects of IVIG

Answer 35

List for IVIG Complications:
● Fever
● Aseptic meningitis
● Hemolytic anemia
● Neutropenia
● Acute kidney injury
● Hyponatremia
● Thromboembolism
● Anaphylaxis (more common in IgA deficiency)
● Plus all the other normal transfusion reactions you can get…
● Delay immunization with live vaccines x 11 months post IVIG.
Can get thrombosis w IVIG, and rarely renal involvement w KD, but labs consistent with hemolysis.

Question 36

Criteria for MAS

Answer 36

Question 37

Answer 37

Eczema Herpeticum