Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RC: Specialties Woo Hoo > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

Child w/ abdo pain + arthritis. Purpura on buttocks. Likely Dx? MOST common cause of long-term morbidity?

A
  1. Henoch Schonlein Purpura

2. HTN and renal Dx

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

What is Henoch Schonlein Purpura?

A
  • vasculitis of small vessel
  • typically 4-6 y.o.
  • IgA deposition
  • URTI 1-3 wk before CC
  • Triad: Palpable Purpuric rash + Arthritis + Abdo Pain
  • No coag
  • U/A monthly till 6 mo. and F/U for HTN
  • Rare complications: hematuria, HTN, V/D, intussusception, neuro (h/a, sz), pul hemm
  • 1/3 cases recur
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is HSP Dx criteria?

A 
Petechiae/purpura + min. 1 of:
> arthritis/ arthralgia
> abdo pain
> renal
> histopathology (IgA deposition)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

T or F: amount of arthritis dictate long term prognosis in HSP.

A

False.

- Severity of nephritis key (HTN, CKD)

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

List 3 complication of arthritis:

A
  • Flexion contracture
  • Leg length discrepancy
  • Growth retardation
  • Osteoporosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

3 y.o. right knee swelling. Best initial tx?

  • steroid
  • MTX
  • NSAID
A

NSAID

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

Mono arthritis x few weeks. Likely test result

  • (+) RF
  • (+) ANA
  • (+) WBC
  • (+) ESR
  • decreased Hgb
A

(+) ESR

Note: RF only if poly; help with prognosis

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

Post reactive arthritis with painless contracture. 3 non-pharm tx:

A
  1. Stretching/ Physio
  2. Bracing
  3. Botox
  4. Surgical
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Monoarthritis. Name 3 meds from different class for Tx:

A
  1. NSAID
    - ibuprofen, naproxen
  2. Dx Modifying AntiRheumatic Drug (DMARD)
    - MTX (hep, pneumonitis, hepatitis, cytopenia)
  3. Systemic Corticosteroids
  4. Cytotoxic agent= Cyclosporine
  5. Biologic
    - Adalimumab, Infliximab
  6. Immunosuppressant
    - Mycophenolate Mofetil
    - Cyclophosphamide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which is best confirmatory test for juvenile dermatomyositis?

  • EMG
  • CK
  • ANA
A

EMG or BX

Key feature= proximal muscle weak + rash (Gottron knuckle, Heliotrope)

Other feature: Nailfold capillary dilatation, myalgia

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

Rheumatic fever mnemonic?

A

JONES= prior strep + 2 major or 1 major and 2 minor

Joints= migratory polyrarthritis
O = draw hear instead= carditis
N= nodules, subcutaneous 
E= erythema marginatum
S= sydenham chorea

Minor: fever, arthralgia, ESR, CRP

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

Migratory polyarthritis. Likely dx?

A

acute rheumatic fever

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

How do you treat acute rheumatic fever?

A
  1. bed rest and watch for carditis
  2. ambulate once signs of ARF subsided
  3. Abx: 10d pen to eradicate strep infection
  4. ASA x 2mo (or joint pain resolves) or steroids if carditis

Secondary prophylaxis:

  • ARF carditis but no heart dx= 10 yr or until 21 y.o.
  • ARF without carditis= 5 yr or until 21 (whichever longer)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Child with migratory arthritis, fever, normal echo. ASOT high. Tx:

  • ASA until arthritis gone
  • ASA PRN and 10d pen
  • ASA until arthritis gone and 10 d pen
  • ASA until arthritis resolve, 10d pen, IM monthly pen
A

ASA until arthritis resolves
Tx 10 d w/ pen
Then q monthly IM pen

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

What is Reiter syndrome? list 4 organisms that could be linked to this

A

Reiter Syn:

  • Uveitis, Urethritis, Arthritis
  • can’t see, can’t pee, can’t climb a tree

4 organisms: Chlamydia trachoma’s, Salmonella, Shigella, Ureaplasma

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

8 y.o. choreoathetotic movement. Handwriting worse. Emotionally labile. Throat Cx (-). Likely dx?

  • Huntington’s chorea
  • Sydenham’s chorea
  • SLE
A

Sydenham’s chorea

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

List a ddx for chorea

A

chorea= brief + random + all over

Genetic: Huntington, Ataxia Telangiectasis

Structural: Stroke, Mass, MS

Parainfectious/AI: Sydenham, SLE

Infection: HIV, Toxo

Metabolic: Na, Ca, thyroid

18
Q

What is sydenham chorea?

A

Neuro manifestation of rheumatic fever (due to Group A strep)

19
Q

What is the most common acquired case of chorea?

A

Sydenham Chorea (from ARF)

20
Q

What is Sydenham chorea classic ppt?

A

Chorea
+ Emotional Lability
+ Hypotonia

21
Q

When does sydenham chorea usually resolve

A

6-9 month

if impairing f’n= VPA, carbmazepine

22
Q

Rheumatic fever. What causes long-lasting problems

A

Carditis

  • arthritis and chorea resolve without sequelae
  • longterm= heart
23
Q

Recurrent fever. Evanescent rash. Lymphadenopathy. MSK normal. Dx?

A

Systemic JIA

24
Q

How do you define systemic JIA

A

arthritis w/ or preceded by fever min. 2 wk

(note quotidian= daily fever x 3 d)

\+ min 1 OF
> evanescent red rash
> node
> HSM
> serositis
25
Q

T or F: systemic JIA is typically easy to control.

A

False.

Esp poor prognosis if

  • polyarticular
  • fever x 3 mo
  • BW high x 6 mo.
26
Q

Features of KD include all except:

  • ++ WBC
  • ANA (-)
  • Plt low
  • urine 10-15
A

Plt low

BW:

  • WBC ++
  • Anemia
  • ++ plt after wk 1
  • ++ CRP, ESR
  • low albumin
  • low Na
  • sterile pyuria
27
Q

12 y.o. 2 wk fever, arthralgia, myalgia. Pale. Blood and protein urine. Plt normal.

  • ARF
  • Wegner’s granulomatosis
  • SLE
  • Juvenile rheum arthritis
A

SLE

28
Q

What is a SLE Mnemonic?

A 
Need 4 of 11
"SOAP BRAIN MD"
S= serositis (pleuritis, pericarditis)
O= oral or nasal ulcer (painless)
A= arthritis (oligo or poly)
P= photosensitivity, pul fibrosis
B= blood (all line low)
R= renal, raynaud
A= ANA (+)
I= immune (anti-Sm, anti-dsDNA, antiphospholipid)
N= neuro (Sz, psychosis)
M=malar rash
D= discoid rash
29
Q

3 tests to confirm dx of Juvenile Dermatomyositis

A

Muscle enzyme (CK, AST, ALT, LDH)

EMG change (short small motor unit, (+) sharp wave)

Muscle Bx (necrosis, inflammation)

30
Q

Mainstay treatment of juvenile dermatomyositis?

A

Steroids

Next:

  • MTX
  • IVIG
  • Plaquenil
  • Cyclosporine
  • MMF
  • Rituximab
31
Q

What are 5 criteria for KD

A

CRASH + Burn

> Fever x 5 d
Conjunctivitis (b/l, non purulent)
Rash (polymorph)
Adenopathy (cervical, > 1.5 cm, unilateral)
Strawberry tongue (cracking of lips, mucosa injection)
Hands (extreme red, swelling and then desquamation)

32
Q

2 findings of P/E for ankylosing spondylitis? Two tests to help with dx.

A
  • Sacroiliac tenderness (FABER)
  • Schober test (< 5 cm increase with forward flexion)

Tests to Dx:

  • HLA B27 (+)
  • MRI (bone marrow edema next to joint)
33
Q

Rash over back of hands, muscle pain, teased for weakness.

  • DMD
  • JDM
  • SLE
A

Juvenile Dermatomyositis

34
Q

Boys with Fever, rash, b/l conjunctivitis. Dry cracked lips. Most likely lab finding?

  • low albumin
  • neutropenia
  • EBV (+)
  • (+) ASOT
A

Low albumin

35
Q

Child w/ pulmonary findings, eosinophilia, slightly high Ca2+.

  • Miliary TB
  • sarcoidosis
  • cryptococcus
  • blastomycosis
A

Sarcoidosis

36
Q

What are the dx criteria of JIA

A

age < 16
+ arthritis (swelling or effusion or 2 of: ROM, warmth, tender on pain or motion)
+ duration min. 6 wk

Oligo= max 4
Poly = min. 5
37
Q

Which complication are you at risk for if JIA?

A

Uveitis

** kids with oligo (max 4 joint), ANA (+), and onset earlier than 5 at risk for chronic uveitis

38
Q

Three ways maternal SLE affect neonate:

A

Due to passive transfer of maternal immunoglobulin IgG autoantibody to fetus.

  1. Heart block (from prolonged PR to complete block; permanent)
  2. Rash (annular or macular; esp face; last 4mo.)
  3. Low Plt
  4. Hepatitis
39
Q

Sunburst Pic on XR. Dx?

A

Osteosarcoma

  • teen (versus Ewing <10 or > 20)
  • long bone
  • local pain, limp
  • chemo
40
Q

Periosteal reaction on XR. Another word for that and likely CA dx?

A

Onion skinning

Ewing Sarcoma

41
Q

What puts kid with JIA at higher risk of uveitis:

  • being 9 y.o.
  • course severity
  • M
  • ANA (+)
A

ANA (+)

42
Q

List complications of uveitis

A
  • Synechiae (irregular pupil)
  • Glaucoma
  • Cataract
  • Vision Loss

RC: Specialties Woo Hoo (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions