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Med Finals - Paediatrics > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Define juvenile idiopathic arthritis

A

Refers to a condition affecting children and adolescents where autoimmune inflammation occurs in the joints.

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2
Q

Define systemic JIA

A

Still’s Diesease- systemic illness that can occur throughout child hood, is idiopathic inflammatory condition
Subtle salmon pink rash
High swinging fevers
Enlarged node
Weight loss
Splenomegaly
Muscle pain

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3
Q

Define polyarticular JIA

A

Idiopathic arthritis in 5 joints of more. Often symmetrical and can affect small joints of hands and feet.

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4
Q

Define oligoarticular JIA

A

JIA involving 4 joints of less
Affects largers joints often knee and ankle
Associated with anterior uveitis

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5
Q

Define enthesitis related arthritis

A

Inflammatory arthritis in the joints and entheses - tendons insert onto bone.

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6
Q

Define psoriatic arthritis

A

Arthritis associated with psoriasis
Poly arthritis affecting small joints

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7
Q

Clinical signs of psoriatic arthritis

A

Plaques of psoriases
Pitting of nails
Onycholysis
Dactylitis
Enthesitis

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8
Q

Management of JIA

A

NSAIDs
Steroids - oral, IM or intra-articular
DMARDs
Biologics
MDT - physio

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9
Q

Define Ehlers-Danlos syndrome

A

Encompasses a group of genetic conditions that cause defects in collagen resulting in hypermobility of patients joints skin bones and blood vessles .

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10
Q

Presentation of EDS

A

Hypermobility
Joint pain
Dislocations
Soft stretchy skin
Easy bruising
Poor healing wounds
Bleeding
HEadaches
Autobnomic dysfunction
GORD
Abdo pain
IBS
MEnorrhagia
Dysmenorrhea
PRemature rupture of membranes
Urinary incontinence
Pelvic organ prolapse
Temporomandibular joint dysfunction
Myopia

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11
Q

What is the coring system for hypermobility

A

Beighton score - 1 point for each side, high score =more likely hypermobile
Palms flat on floor with straight legs -1 point
Elbows hyperextend
Knees hyperextend
Thumb can bend to touch the forearm
Little finger hyper extends past 90 degrees

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12
Q

Management of EDS

A

MDT
Physio
OT
Psychology

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13
Q

Define Henoch-Schonlein purpura

A

IgA vasculitis that presents with a purpuric rash affecting lower limbs and buttocks in children
Affects skin, kidneys an gi tract

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14
Q

Classic features of Henoch-Schonlein purpura

A

Purpura
Arthralgia or arthritis 75%
Abdo pain 50%
IgA nephritis 50%

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15
Q

Investigations in henoch-schonlein purpura

A

Bloods - FBC, UE, Albumin, CRP, cultures
Dipstick
Protein creatinine ratio
Blood pressure

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16
Q

Management of Henoch-Schonlein purpura

A

Supportive management
Steroids?
Good monitoring - blood pressure and dipstick

17
Q

Define Kawasaki disesase

A

Mucocutaneous lymph node syndrome - systemic medium sized vasculitis. Affting younger children

18
Q

Complication of Kawasaki disease

A

Coronary artery aneurysm

19
Q

Clinical features of kawasaki diseas

A

Persistent high fever - >5 days
Wide spread erythematous maculopapular rash with desquamation - skin peeling - on palms and soles
Strawberry red tongue
Cracked lips
Cervical lymphadenopathy
Bilateral conjunctivitis

20
Q

Investigations in Kawasaki disease

A

FBC
LFT
EST
Urinalysis
Echocardiogram!

21
Q

Management of Kawasaki disese

A

High dose aspirin
Iv Ig
Follow up echo

22
Q

Define rheumatic fecer

A

An autoimmune condition triggered by streptococcus bacteria - multisystem disorder that affects the joints, heart, skin and nervous system

23
Q

Presentation of rheumatic fever

A

2-4 weeks post streptococcal infection tonsillitis
Fever
Joint pain
Rash
Shortness of breath
Chorea
Nodules
Carditis,

24
Q

Investigations in rheumatic fever

A

Throat swab
ASO titres
Echocardiogram

25
Q

Criteria for diagnosis in rheumatic fever

A

JONEs criteria
JONES - FEAR
Major
Joints
Organ inflammation - carditis
Nodules
Erythema marginatum
Sydenham chorea

Minor
Fever
ECG
Arthralgia
Raised CRP and ESR

26
Q

Management of rheumatic fever

A

NSAIDS
Aspirin and steroids
Prophylactic antibiotics

Med Finals - Paediatrics (17 decks)

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