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MCQ by topic > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Classification of JIA

How many joints in oligo?
How many in polyarticular?

A

Classification of Juvenile
Idiopathic Arthritis JIA (1998)
1. Oligoarticular: < 4 joint
- Persistent
- Extended
2. Polyarticular: ≥ 5 joints
- RF positive
- RF negative
3. Systemic: fever, rash
4. Enthesitis related arthritis
5. Psoriatic arthritis: Psoriasis and arthritis
6. Undifferentiated

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2
Q

What classifies as arthritis?

A
  • Joint Swelling or Effusion
    OR
  • ≥2 of the following:
  • Limited ROM
  • Tenderness or pain on motion
  • Increased heat
    (second criteria used more for joints that you cant see like hip joints)
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3
Q

Juvenile = started in childhood at what age?
* Idiopathic = Other causes of arthritis ruled out, such as infection, injury, etc.
* Arthritis = joint inflammation more than HOW MANY WEEKs, pain, tenderness, swelling, warmth, loss of movement, stiffness)
* NO DIAGNOSTIC TEST!!

A

Juvenile = started in childhood < 16 years age)
* Idiopathic = Other causes of arthritis ruled out, such as infection, injury, etc.
* Arthritis = joint inflammation more than 6 weeks pain, tenderness, swelling, warmth, loss of movement, stiffness)
* NO DIAGNOSTIC TEST!!

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4
Q

Enthesitis related arthritis more common in girls or boys?

A

Boys

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5
Q

Name two infections which can cause CHRONIC arthritis

A

TB and Lyme

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6
Q

JIA and sJIA more common in boys or girls?

A

girls

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7
Q

Which type of arthritis is linked to IBD?

A

enthesistis related

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8
Q

gonococcal arthritis typically affects what joint?

A

knee (usually very painful)

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9
Q

what virus can cause acute polyarthritis?

A

parvovirus

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10
Q

How many days does Kingella kingae need to grow on culture?

A

up to 7 days, normal joint aspirations, cultures only cultured for 5 days

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11
Q

What are Kochers criteria to differentiate septic arthritis from other causes of arthritis?

A

Septic Arthritis of the hip:
Kocher’s Criteria
* Refusal to weight bear
* Fever (oral temperature >38.5° Cor 101.5° F)
* 1WBC (>12,000/mm3)
* 1 Inflammatory Markers
(ESR (>40mm/hr) or
^CRP (>20mg/dL)
* 0/4: 0.2%
* 1/4:3%
* 2/4: 40%
* 3/4: 93%
* 4/ 4:99.6%

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12
Q

Minor criteria for ARF (4)

A
  • Fever
  • Arthralgia
  • Increased ESR, CRP
  • ECG changes:
    Prolonged PR interval
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13
Q

JONES major criteria for ARF

A
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14
Q

How many major and minor criteria do you need to meet jones criteria?

A

2 major OR 1 major and 2 minor with evidence of recent strep infection

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15
Q

Epidemiology and clinical presentation of oligoarticular JIA

A
  • Peak onset age 1-3 yo
  • Girls > boys
  • Large joints - knee most common, flexion contracture (also ankles, wrists, elbows)
  • ANA positive in 80%
  • RF negative (has to be negative)
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16
Q

Risk factors for asymptomatic uveitis associated with JIA

A

Girls
Young onset age
Oligoarticular JIA
ANA positivity

17
Q

6 complications of JIA

A
18
Q

A 4 year old girl presents with a left knee effusion for 1 month.
She limps in the morning but is otherwise well. While awaiting the results of your initial investigations which of the following would be most appropriate?
1. Treat with naproxen and reassess in 2-3 weeks.
2. Inject the knee with a long-acting corticosteroid
3. Aspirate synovial fluid from the knee for symptomatic relief
4. Treat with naproxen for I week followed by a short course of prednisone if there is no improvement
5. Refer to a rheumatologist before initiating any treatment.

A

Dont use steroids. Can mask bad things like malignancy and infection.
If you aspirate fluid it will just reaccumulate.

19
Q

Treatment for oligoarticular JIA

A
20
Q

Clinical presentation of RF- polyarticular JIA

A
21
Q

Clinical presentation of RF+ polyarticular JIA

A

Usually more severe arthritis

22
Q

Clinical presentation of Enthesistis related arthritis

A
23
Q

Rheumatologic causes of MAS (3)

A

sJIA, kawasaki, SLE

24
Q

Which antibodies are sensitive for diagnosis of lupus? Which antibodies are specific for lupus?

A

ANA–>sensitive
anti-DNA, anti-Sm–>specific
antiphospholipid antibodies, anti RNP, anti Ro, Anti-La also often positive

25
Q

4 features of anti phospholipid antibody syndrome

A

thromboses, thrombocytopenia, recurrent abortion, hemolytic anemia

26
Q

3 parts of anti phospholipid antibody syndrome diagnosis

A

prolonged PTT, anticardiolipin antibodies, lupus anticoagulant

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