Rheumatology

Question 1

Diagnostic Criteria for Kawasaki

Not all features have to occur at the same time

Answer 1

4 out of 5

1. polymorphous rash
2. bilateral (non purulent) conjunctival injection
3. mucous membrane changes, e.g. reddened or dry cracked lips, strawberry tongue, diffuse redness of oral or pharyngeal mucosa
4. peripheral changes, e.g. erythema of the palms or soles, oedema of the hands or feet, and in convalescence desquamation (occurs in week 2)
5. cervical lymphadenopathy (> 15 mm diameter, usually unilateral, single, non purulent and painful)

Question 2

What is the risk of coronary a. aneurysms in children with atypical Kawasaki?

Answer 2

The same as Kawasaki

Question 3

1. What occurs to platelets in Kawasaki?

Answer 3

1. Marked Thromboyctosis (Can be low at diagnosis)

Question 4

1. What is the treatment of Kawasaki?

Answer 4

IVIG & Aspirin

Question 5

What are the complications of SLE?

Answer 5

SOAP BRAIN MD

Serositis (pleurisy, pericarditis)
Oral ulcers (Painless vs apthous ulcers)
Arthritis
Photosensitivity

Blood disorders 
Renal disorder 
Antinuclear antibodies (>1:160) 
Immunological 
Neurology (Seizures, Psychosis) 

Malar Rash
Discoid Rash

Question 6

What are the ddx for painful limb?

Answer 6

Arthritis
Septic Arthritis
Infection: TB, Rheumatic Fever
Mechanical
Malignancy: Systemic or local malignancy
Paediatric pain syndromes: Dermatomyositis, HSP, Scleroderma

Question 7

What are the loose criteria for growing pains?

Answer 7

Bilateral (not in same night, over course of a week)
Can occur every night for 2 wks then better or May occur x2/wk
Must affect one joint then another
>Calf/Thigh/Shin pain
>3-10 year old age group

Normal physical examination & bloods