Rheumatology

Question 1

Sacroiliitis
Bamboo spine
Gets better with activity
+HLA B27
Associated with IBD, uveitis, aortitis

Answer 1

Ankylosing spondylitis

Question 2

Malar rash or heliotropic
< 10 yo
Proximal Muscle weakness
Scaly skin (gottrons sign)
Periungual red bumps (telangiectasias)
Elevated CK

Answer 2

Juvenile dermatomyositis

Question 3

Labs to order for diagnosis of juvenile dermatomyositis

Answer 3

CPK
LDH
aldolase

Question 4

Most common systemic vasculitis in children

Answer 4

Henoch schonlein purpura

Question 5

Palpable purpura
Abdominal pain
Hematuria, proteinuria, azometemia, HTN

Answer 5

Henoch schonlein purpura

(IgA vasculitis)

Question 6

Most common rheumatologic disease in childhood

Answer 6

Juvenile idiopathic arthritis

Question 7

Morning stiffness
Arthritis
<16 yo
+ANA
Uveitis (oligoarticular)

Answer 7

Juvenile idiopathic arthritis

Question 8

Complications of juvenile idiopathic arthritis

Answer 8

High fevers
Leukocytosis
Rash - salmon colored with central clearings which coalesce and are evanescent
HSM
LAD
Pleuritis, pericarditis, serositis

Question 9

1 treatable cause of blindness in children.

Answer 9

Chronic uveitis

Question 10

Treatment for juvenile idiopathic arthritis

Answer 10

PT/OT
#1 NSAIDs
#2 steroids + immunosuppressants
Methotrexate (gold standard)

Question 11

Main side effects of methotrexate

Answer 11

Folate antagonist
GI distress
Pulmonary toxicity

Question 12

Criteria for Kawasaki disease

Answer 12

Fever > 5 days
Cervical LAD
Oropharyngeal findings
Bilateral conjunctivitis (not Exudative)
Diffuse rash
Erythema/edema of hands/feet

Question 13

Sterile pyuria
CNS symptoms
Migratory Polyarthritis
Hydrops in gallbladder
Thrombocytosis

Answer 13

Minor symptoms of Kawasaki disease

Question 14

Complication of Kawasaki disease

Answer 14

Coronary artery aneurysm/vasculitis

Question 15

Treatment for Kawasaki disease

Answer 15

IVIG - 2g/kg
Aspirin 80mg/kg/day following by maintenance therapy if 5mg/kg/day

Question 16

Duration to avoid measles and varicella vaccines after IVIG

Answer 16

11 mo

Question 17

Erythema chonicum migrans

Answer 17

Lyme disease

Borrelia burgdorferi
Ixodes deer tick

Question 18

Best way to prevent Lyme disease

Answer 18

Frequent tick checks

Question 19

First 2 week symptoms of Lyme disease

Answer 19

Erythema chronicum migrans
Arthralgia
Fatigue

Question 20

Several month symptoms of Lyme disease

Answer 20

CNS (Bells palsy)
Cardiac
Arthritis

Question 21

Diagnosis and treatment for Lyme disease

Answer 21

Lyme EIA or FA
Western blot (confirmatory)

Doxycycline if > 8 yo
Amoxicillin if < 8 yo

Question 22

Treated for Lyme disease
Fevers. Chillls
Sepsis

Answer 22

Jarisch-herxheimer reaction

(Release of endotoxin)

Question 23

Arthritis
Uveitis
Urethritis
+ HLA B27
GI or GU infection

Answer 23

Reactive arthritis

Question 24

Most common cause of reactive arteries in the US

Answer 24

Chlamydia trachomatis

Question 25

Weight loss. Fatigue Hilar adenopathy. Bilateral peribronchial cuffing Chronic cough African Americans Noncasesting granuloma

Answer 25

Sarcoidosis Arthritis Rash Uveitis

Question 26

Complications of sarcoidosis

Answer 26

Hypercalcemia Hypercalciuria Cardiac

Question 27

Linear hypopigmented patch Brown border

Answer 27

Localized linear scleroderma

Question 28

Treatment for localized linear scleroderma

Answer 28

Topical lubricants Photochemotherapy Steroids Anti malaria ms Immunosuppressant

Question 29

Sclerodactyly Pulmonary fibrosis Reflux/dysphagia Raynaud Renal crisis syndrome +ANA +Anti topoisomerase +Anti RNA polymerase

Answer 29

Systemic scleroderma

Question 30

Diagnostic criteria for SLE

Answer 30

Malar or discoid rags Photosensitivity Oral ulcerations Arthritis and serositis Hematologic abnormalities Renal abnormalities CNS/psych abnormalities + Anti dsDNA, anti-Smith + ANA

Question 31

Rash 3rd degree heart block Hydrops fetalis +Anti SSA

Answer 31

Neonatal lupus

Question 32

Periodic fever Aphthous stomatitis Pharyngitis Cervical adenitis Treatment

Answer 32

PFAPA syndrome Prednisone

Question 33

Fever Abdominal pain Testicular pain Knee/ankle swelling

Answer 33

Familial Mediterranean fever