Rheumatology

Question 1

Treatment dermatomyositis

Answer 1

High dose steroids (#1) until CK normalizes, MTX, avoid sunlight

Question 2

Hypermobile joints, blindness, intellectual disability, hypotonia

Answer 2

Lowe’s syndrome

Question 3

Which type of JIA is associated with uveitis, ANA+

Answer 3

Pauciarticular/Oligoarthritis

Question 4

Requirements to dx kawasaki disease

Answer 4

Fever for at least 5 days, and at least 4/5:

Cervical adenopathy, Extremity swelling, polymorphous rash on trunk, conjunctivitis, swollen tongue/dry fissured lips

Question 5

How to dx Lyme disease

Answer 5

Lyme antibody titer and confirm with western blot

Question 6

Tx Lyme disease

Answer 6

Doxycycline if >8

Amoxicillin if <8

Question 7

How to track severity of lupus?

Answer 7

C3 and C4 will go down with more active/acute disease

Question 8

Most sensitive test in lupus? Most specific?

Answer 8

ANA (almost all are +); Anti-dsDNA (positive rules it in)

Question 9

How to follow active renal disease in SLE

Answer 9

Increased anti-DNA titers, decreased levels of C3, C4, and CH50

Question 10

What antibody is frequently positive in drug induced lupus?

Answer 10

Anti-histone

Question 11

When does the renal involvement occur in HSP? How to monitor?

Answer 11

Can occur 3 months after disease onset. Check urine weekly x 3 months, then monthly x 3 months

Question 12

HSP is a vasculitis of which vessels? Kawasaki?

Answer 12

HSP- small vessels, Kawasaki- medium vessels

Question 13

When should aspirin be dc’d in kawasaki disease?

Answer 13

When all acute phase reactants return to normal

Question 14

What labs to check in sarcoidosis

Answer 14

Calcium, Vitamin D, ESR, CRP

Question 15

What conditions place patients at increased risk of SCIFE?

Answer 15

hypogonadal conditions, hypothyroidism, growth hormone therapy, and renal osteodystrophy

Question 16

Recurrent episodes lasting <1 day, which include 2 or more of the following: fever, abdominal pain, chest pain, arthritis, and a family history of the disorder

Answer 16

Familial Mediterranean fever (recurrent polyserositis)

Question 17

8 yo girl with a temp 102.4° F with exudative pharyngitis, several aphthae on the buccal mucosa, and tender anterior cervical lymphadenopathy. Similar signs and symptoms both 5 and 11 weeks earlier. Dx? How to tx?

Answer 17

Periodic fever with Aphthous ulcers, pharyngitis and Adenitis. Tx with steroids

Question 18

Tx pityriasis rosea

Answer 18

Sun exposure

Question 19

Papular lesion on the foot sole in a child walking barefoot at pool .Caused by what?

Answer 19

Atypical mycobacteria

Question 20

Non-scaling erythematous annular lesion on skin

Answer 20

Granuloma annulare

Question 21

Tx tinea capitis

Answer 21

PO griseofulvin 6-12 weeks

Question 22

What to monitor for in kids with NF1?

Answer 22

Pheochromocytoma and renal artery stenosis

Question 23

Treatment of onychomycosis

Answer 23

Oral terbinafine or itraconazole

Question 24

When should infantile acne resolve?

Answer 24

After 3 months of age

Question 25

Most common organism with giannoti crosti?

Answer 25

EBV