Rheumatology Flashcards
Sacroiliitis
Bamboo spine
Gets better with activity
+HLA B27
Associated with IBD, uveitis, aortitis
Ankylosing spondylitis
Malar rash or heliotropic
< 10 yo
Proximal Muscle weakness
Scaly skin (gottrons sign)
Periungual red bumps (telangiectasias)
Elevated CK
Juvenile dermatomyositis
Labs to order for diagnosis of juvenile dermatomyositis
CPK
LDH
aldolase
Most common systemic vasculitis in children
Henoch schonlein purpura
Palpable purpura
Abdominal pain
Hematuria, proteinuria, azometemia, HTN
Henoch schonlein purpura
(IgA vasculitis)
Most common rheumatologic disease in childhood
Juvenile idiopathic arthritis
Morning stiffness
Arthritis
<16 yo
+ANA
Uveitis (oligoarticular)
Juvenile idiopathic arthritis
Complications of juvenile idiopathic arthritis
High fevers
Leukocytosis
Rash - salmon colored with central clearings which coalesce and are evanescent
HSM
LAD
Pleuritis, pericarditis, serositis
1 treatable cause of blindness in children.
Chronic uveitis
Treatment for juvenile idiopathic arthritis
PT/OT
#1 NSAIDs
#2 steroids + immunosuppressants
Methotrexate (gold standard)
Main side effects of methotrexate
Folate antagonist
GI distress
Pulmonary toxicity
Criteria for Kawasaki disease
Fever > 5 days
Cervical LAD
Oropharyngeal findings
Bilateral conjunctivitis (not Exudative)
Diffuse rash
Erythema/edema of hands/feet
Sterile pyuria
CNS symptoms
Migratory Polyarthritis
Hydrops in gallbladder
Thrombocytosis
Minor symptoms of Kawasaki disease
Complication of Kawasaki disease
Coronary artery aneurysm/vasculitis
Treatment for Kawasaki disease
IVIG - 2g/kg
Aspirin 80mg/kg/day following by maintenance therapy if 5mg/kg/day
Duration to avoid measles and varicella vaccines after IVIG
11 mo
Erythema chonicum migrans
Lyme disease
Borrelia burgdorferi
Ixodes deer tick
Best way to prevent Lyme disease
Frequent tick checks
First 2 week symptoms of Lyme disease
Erythema chronicum migrans
Arthralgia
Fatigue
Several month symptoms of Lyme disease
CNS (Bells palsy)
Cardiac
Arthritis
Diagnosis and treatment for Lyme disease
Lyme EIA or FA
Western blot (confirmatory)
Doxycycline if > 8 yo
Amoxicillin if < 8 yo
Treated for Lyme disease
Fevers. Chillls
Sepsis
Jarisch-herxheimer reaction
(Release of endotoxin)
Arthritis
Uveitis
Urethritis
+ HLA B27
GI or GU infection
Reactive arthritis
Most common cause of reactive arteries in the US
Chlamydia trachomatis
Weight loss. Fatigue
Hilar adenopathy. Bilateral peribronchial cuffing
Chronic cough
African Americans
Noncasesting granuloma
Sarcoidosis
Arthritis
Rash
Uveitis
Complications of sarcoidosis
Hypercalcemia
Hypercalciuria
Cardiac
Linear hypopigmented patch
Brown border
Localized linear scleroderma
Treatment for localized linear scleroderma
Topical lubricants
Photochemotherapy
Steroids
Anti malaria ms
Immunosuppressant
Sclerodactyly
Pulmonary fibrosis
Reflux/dysphagia
Raynaud
Renal crisis syndrome
+ANA
+Anti topoisomerase
+Anti RNA polymerase
Systemic scleroderma
Diagnostic criteria for SLE
Malar or discoid rags
Photosensitivity
Oral ulcerations
Arthritis and serositis
Hematologic abnormalities
Renal abnormalities
CNS/psych abnormalities
+ Anti dsDNA, anti-Smith
+ ANA
Rash
3rd degree heart block
Hydrops fetalis
+Anti SSA
Neonatal lupus
Periodic fever
Aphthous stomatitis
Pharyngitis
Cervical adenitis
Treatment
PFAPA syndrome
Prednisone
Fever
Abdominal pain
Testicular pain
Knee/ankle swelling
Familial Mediterranean fever
