Rheumatology Flashcards
Define juvenile idiopathic arthritis
Refers to a condition affecting children and adolescents where autoimmune inflammation occurs in the joints.
Define systemic JIA
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
Define polyarticular JIA
Idiopathic arthritis in 5 joints of more. Often symmetrical and can affect small joints of hands and feet.
Define oligoarticular JIA
JIA involving 4 joints of less
Affects largers joints often knee and ankle
Associated with anterior uveitis
Define enthesitis related arthritis
Inflammatory arthritis in the joints and entheses - tendons insert onto bone.
Define psoriatic arthritis
Arthritis associated with psoriasis
Poly arthritis affecting small joints
Clinical signs of psoriatic arthritis
Plaques of psoriases
Pitting of nails
Onycholysis
Dactylitis
Enthesitis
Management of JIA
NSAIDs
Steroids - oral, IM or intra-articular
DMARDs
Biologics
MDT - physio
Define Ehlers-Danlos syndrome
Encompasses a group of genetic conditions that cause defects in collagen resulting in hypermobility of patients joints skin bones and blood vessles .
Presentation of EDS
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
What is the coring system for hypermobility
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
Management of EDS
MDT
Physio
OT
Psychology
Define Henoch-Schonlein purpura
IgA vasculitis that presents with a purpuric rash affecting lower limbs and buttocks in children
Affects skin, kidneys an gi tract
Classic features of Henoch-Schonlein purpura
Purpura
Arthralgia or arthritis 75%
Abdo pain 50%
IgA nephritis 50%
Investigations in henoch-schonlein purpura
Bloods - FBC, UE, Albumin, CRP, cultures
Dipstick
Protein creatinine ratio
Blood pressure
Management of Henoch-Schonlein purpura
Supportive management
Steroids?
Good monitoring - blood pressure and dipstick
Define Kawasaki disesase
Mucocutaneous lymph node syndrome - systemic medium sized vasculitis. Affting younger children
Complication of Kawasaki disease
Coronary artery aneurysm
Clinical features of kawasaki diseas
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
Investigations in Kawasaki disease
FBC
LFT
EST
Urinalysis
Echocardiogram!
Management of Kawasaki disese
High dose aspirin
Iv Ig
Follow up echo
Define rheumatic fecer
An autoimmune condition triggered by streptococcus bacteria - multisystem disorder that affects the joints, heart, skin and nervous system
Presentation of rheumatic fever
2-4 weeks post streptococcal infection tonsillitis
Fever
Joint pain
Rash
Shortness of breath
Chorea
Nodules
Carditis,
Investigations in rheumatic fever
Throat swab
ASO titres
Echocardiogram
Criteria for diagnosis in rheumatic fever
JONEs criteria
JONES - FEAR
Major
Joints
Organ inflammation - carditis
Nodules
Erythema marginatum
Sydenham chorea
Minor
Fever
ECG
Arthralgia
Raised CRP and ESR
Management of rheumatic fever
NSAIDS
Aspirin and steroids
Prophylactic antibiotics
