Rheumatology

Question 1

What are the three main juvenile idiopathic arthritis

Answer 1

1. Systemic
2. Pauciarticular
3. Polyarticular

Question 2

For the three main juvenile idiopathic arthritis, what is systemic arthritis presentation and diagnosis

Answer 2

Intermittent fevers, rash, lymphadenopathy, and arthritis

Diagnosis criteria: Daily fever for two weeks and arthritis

Question 3

What is the treatment for systemic juvenile idiopathic arthritis

Answer 3

First line: NSAIDs
Second line: Corticosteroids or methotrexate

Long term prognosis: Can go anywhere from no destruction to full joint destruction

Question 4

What are pearls of pauciarticular JIA do I need to know

Answer 4

Involves < 5 joints and it’s the large ones

Patients are ANA positive

Treatment same as systemic

People get uveitis so need ophthalmologist every 3-12 months

Question 5

What are the pearls of polyarticular JIA do I need to know

Answer 5

Age of onset 2-5 years and 10-14 years

Patients ANA and/or RF positive

Treatment: Must use DMARDS unlike other two
RF-seronegative patients: NSAIDs
RF-seropositive patients: DMARDS

Uveitis screening by opthalmologist

Question 6

What is henoch-schonlein purpura

Answer 6

Most common small vessel vasculitis of childhood, usually get URI two-three weeks earlier

Question 7

What are the symptoms of henoch-schonlein purpura

Answer 7

Palpable purpura, arthritis/arthralgia, abdominal pain, and glomerulonephritis

Renal-involvement self limited

Question 8

What is the diagnosis of henoch-schonlein purpura

Answer 8

Clinical diagnosis

If unclear, get skin/kidney biopsy with IgA deposits

Question 9

What is the treatment of henoch schonlein purpura

Answer 9

Pain control: Acetaminophen or NSAIDs plus glucocorticoids