RHEUMATOLOGY Flashcards

1
Q

A 7-year-old with morning stiffness, knee and
ankle swelling for 2 months, ESR is normal,
antinuclear antibody (ANA) 1:160

A

Oligoarticular juvenile idiopathic arthritis (JIA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

A 2-year-old female with recently diagnosed oligo JIA and positive ANA requires frequent screening for this comorbidity

A

Chronic anterior uveitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Fatigue, weight loss, arthritis in multiple joints for > 6 weeks, positive RF, anti-cyclic citrullinated peptide antibodies present and ANA is negative

A

Polyarticular JIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Fatigue, weight loss, no fever, arthritis in multiple joints, negative RF, ANA is positive

A

Polyarticular JIA with an increased risk of
uveitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

A 5-year-old girl recently diagnosed with JIA, her
ANA is positive; how frequently does she need
screening for uveitis?

A

Every 3–4 months (JIA, < 7 years and positive
ANA is the highest risk of uveitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A 9-year-old girl recently diagnosed with JIA, her
ANA is positive, how frequently does she need
screening for uveitis?

A

Every 6 months (JIA, > 7 years and positive
ANA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

An 8-year-old with knee pain for 6 weeks, noted to have pain, swelling, decreased range of motion, difficulty bearing weight, synovial fluid shows decreased viscosity and WBC 15,000

A

Inflammatory arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Fever, salmon-colored rash with fever and hot
showers, arthritis in major joints, hepatosplenomegaly, leukocytosis, thrombocytosis, anemia of chronic disease, elevated ESR, negative RF, and negative ANA

A

Systemic JIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Side effects include immunosuppression, adrenal suppression, weight gain, cushingoid facies, diabetes and acne

A

Corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

This test is very sensitive but not specific for SLE

A

Antinuclear antibody (ANA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Child with systemic JIA presents with elevated
liver enzymes, prolonged PTT, positive D-dimer,
thrombocytopenia, hyperferritinemia, and low ESR

A

Macrophage activation syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

An African-American girl with pericarditis,
pleurisy, recurrent oral ulcers, hemolytic anemia, and RBC casts in urine

A

SLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Malar rash, arthritis, proteinuria, leucopenia,
thrombocytopenia, positive ANA, and anti-dsDNA

A

Systemic lupus erythematosus (SLE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Autoantibodies associated with arterial/venous
thrombosis or recurrent miscarriage (in patients
with or without SLE)

A

Antiphospholipid antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

The most severe type of lupus nephritis resulting in hematuria, proteinuria, elevated blood pressure and can lead to end-stage renal disease

A

Diffuse lupus nephritis (membranoproliferative,
class IV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Neonate born with heart block, annular erythematous plaques, anemia, thrombocytopenia, and elevated liver enzymes, positive SSA (Ro) and SSB (La) antibodies

A

Neonatal lupus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Recurrent parotitis, xerophthalmia, conjunctivitis, xerostomia, positive ANA, RF, and anti-Ro

A

Sjögren syndrome

18
Q

A 7-year-old female, with proximal muscle
weakness in both sides, arthralgia, heliotrope rash, elevated creatine phosphokinase (CPK) and LDH

A

Juvenile dermatomyositis

19
Q

A 6-year-old female with difficulty climbing stairs and voice change, Gottron papules and abnormal nailfolds, and telangiectasias

A

Juvenile dermatomyositis

20
Q

A 15-year-old had diarrhea positive for Yersinia
2 weeks ago, now is having conjunctivitis,
urethritis, arthritis of the hip and knee

A

Reactive arthritis

21
Q

Adolescent with inflammatory bowel disease
(IBD) has arthritis

A

Arthritis-related to IBD

22
Q

An 8-year-old, pain in the sacroiliac joint,
tenderness, stiffness and joint pain in the morning that improves with activity, and positive HLA-B27

A

Enthesitis-related arthropathies

23
Q

Child with nail pitting, psoriasis, arthritis, positive ANA

A

Juvenile psoriatic arthritis

24
Q

Adolescent with recurrent oral and genital ulcers, positive pathergy test

A

Behçet disease

25
Q

Adolescent girl with chronic left foot pain,
minimal touch aggravates the pain, foot is swollen, warm to touch, and mottled skin

A

Complex regional pain syndrome or reflex
sympathetic dystrophy (RSD)

26
Q

Adolescent, 1 year with fatigue, multiple areas of pain, tenderness, no signs of inflammation, and labs are normal

A

Fibromyalgia

26
Q

A 7-year-old boy with pain in both legs, worse in
the evening, sometimes awakens him from sleep, no fever, no limping, joints are normal on exam, pain responds to ibuprofen and heat massage

A

Growing pain

27
Q

A 5-year-old boy with acute onset palpable
purpura on lower extremities, joint swelling and
abdominal pain, labs reveal normal CBC, PT and
PTT, positive proteinuria

A

Henoch-Schönlein purpura (HSP)

28
Q

An 18-month-old with fever for 6 days, rash,
conjunctivitis, strawberry tongue, and erythema of the palms and soles

A

Kawasaki disease

29
Q

The primary treatment for Kawasaki disease,
ideally given between day 5 and 10 of illness

A

IVIG, aspirin

30
Q

A 15-year-old female with fatigue, weight loss,
recurrent sinusitis, and joint pain. Labs reveal
hematuria, proteinuria, and positive cANCA

A

Granulomatous polyangiitis (GPA, formerly
Wegener granulomatosis)

31
Q

Pain, numbness, and discoloration of fingers (white then blue then red) that is triggered by cold weather

A

Raynaud’s disease

32
Q

A 14-year-old female with severe Raynaud disease with ulceration on her fingertip, tightening of her skin, sclerodactyly, positive ANA, positive anti-Scl-70

A

Systemic sclerosis

32
Q

A 12-year-old female with a linear hyperpigmented lesion on her leg that appears white and sclerotic in the center and has an erythematous border

A

Localized scleroderma

33
Q

A chest radiograph with pulmonary infiltrates and hilar adenopathy, biopsy with non-caseating granulomas, elevated ACE

A

Sarcoidosis

34
Q

Recurrent knee arthritis in an otherwise well child with a prior history of camping in the woods

A

Lyme arthritis

35
Q

Newborn infant presents a few hours after birth
with hypotonia, facial muscle weakness, ptosis,
weak cry, respiratory distress, the mother has a
history of muscle weakness

A

Neonatal myasthenia gravis

36
Q

Adolescent with muscle weakness, worsens with
repetitive movement and at the end of the day,
difficulty breathing, abnormal ocular movement

A

Juvenile myasthenia gravis

37
Q

A 3-year-old child from the Middle East, recurrent fever and abdominal pain, during the episode the ESR and CRP are elevated, WBC 25,000

A

Familial Mediterranean fever

38
Q

Child with fever for 3–5 days every month
associated with mouth ulcers, throat pain, cervical lymphadenitis. The patient is well in- between episodes

A

PFAPA (periodic fever, aphthous stomatitis,
pharyngitis, and cervical adenitis)