RHEUMATOLOGY Flashcards
A 7-year-old with morning stiffness, knee and
ankle swelling for 2 months, ESR is normal,
antinuclear antibody (ANA) 1:160
Oligoarticular juvenile idiopathic arthritis (JIA)
A 2-year-old female with recently diagnosed oligo JIA and positive ANA requires frequent screening for this comorbidity
Chronic anterior uveitis
Fatigue, weight loss, arthritis in multiple joints for > 6 weeks, positive RF, anti-cyclic citrullinated peptide antibodies present and ANA is negative
Polyarticular JIA
Fatigue, weight loss, no fever, arthritis in multiple joints, negative RF, ANA is positive
Polyarticular JIA with an increased risk of
uveitis
A 5-year-old girl recently diagnosed with JIA, her
ANA is positive; how frequently does she need
screening for uveitis?
Every 3–4 months (JIA, < 7 years and positive
ANA is the highest risk of uveitis)
A 9-year-old girl recently diagnosed with JIA, her
ANA is positive, how frequently does she need
screening for uveitis?
Every 6 months (JIA, > 7 years and positive
ANA)
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
Inflammatory arthritis
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
Systemic JIA
Side effects include immunosuppression, adrenal suppression, weight gain, cushingoid facies, diabetes and acne
Corticosteroids
This test is very sensitive but not specific for SLE
Antinuclear antibody (ANA)
Child with systemic JIA presents with elevated
liver enzymes, prolonged PTT, positive D-dimer,
thrombocytopenia, hyperferritinemia, and low ESR
Macrophage activation syndrome
An African-American girl with pericarditis,
pleurisy, recurrent oral ulcers, hemolytic anemia, and RBC casts in urine
SLE
Malar rash, arthritis, proteinuria, leucopenia,
thrombocytopenia, positive ANA, and anti-dsDNA
Systemic lupus erythematosus (SLE)
Autoantibodies associated with arterial/venous
thrombosis or recurrent miscarriage (in patients
with or without SLE)
Antiphospholipid antibodies
The most severe type of lupus nephritis resulting in hematuria, proteinuria, elevated blood pressure and can lead to end-stage renal disease
Diffuse lupus nephritis (membranoproliferative,
class IV)
Neonate born with heart block, annular erythematous plaques, anemia, thrombocytopenia, and elevated liver enzymes, positive SSA (Ro) and SSB (La) antibodies
Neonatal lupus