Rheumatology 🦾

Question 1

7 years old female with eyelid erythema & thickening of skin over metacarpo-phalangeal joints & proximal muscle weakness
A. Juvenile Dermatomyositis
B. Scleroderma
C. SLE
D. Rheumatic fever

Answer 1

A. Juvenile Dermatomyositis

✔️ Heliotrope rash
✔️ Gorton’s papule
Dx: muscle biopsy

Question 2

Child presents with hip and groin pain. An US reveal hip joint effusion. He is afebrile. What is most likely diagnosis?
A. Toxic synovitis
B. Benign acute myositis
C. Osteomyelitis
D. Septic arthritis

Answer 2

A. Toxic synovitis
Most common cause of hip pain in children 3-10 yrs

Question 3

2 years with history of bilateral knee pain and dec movement for 8 weeks. Didn’t respond to daily OTC medications. O/E: redness & hotness both knees
A. SLE
B. Oligo articular JIA
C. Poly articular JIA
D. TB

Answer 3

B. Oligo articular JIA
Oligo <5 joints
Poly >5 joints

Question 4

Salmon rash, hepatosplenomegaly, multiple joint involvement symmetrical & asymmetrical large and small joints:
A. Systemic Idiopathic juvenile arthritis
B. Psoriatic arthritis
C. Polyarticular juvenile
D. Idiopathic arthritis

Answer 4

A. Systemic Idiopathic juvenile arthritis
aka Still disease

Question 5

A child with interphalangeal joint nodules and SQ nodules, next investigations:
A. Rheumatoid factor
B. ANA
C. Anti-streptolysin O titer
D. AntiDnase B

Answer 5

A. Rheumatoid factor

Question 6

7 yo girl history of arthritis in her both hands, She has photosensitivity, ANA +ve. Which will support diagnosis?
A. Petechial rash
B. Myocarditis
C. Seizures
D. Conjunctivitis

Answer 6

C. Seizures
???

Question 7

4 yo with Oligo JIA and +ve ANA
You should screen for ant uveitis
A. Every 3 months
B. Every 6 months
C. Every year
D. Every 2 years

Answer 7

A. Every 3 months

Question 8

Child present high fever and limping you found redness & hotness in left knee joint
Most likely cause
A. Staph aureus
B. Strep viridans
C. TB
D. Salmonella

Answer 8

A. Staph aureus