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Paediatrics > rheumatology > Flashcards

rheumatology Flashcards

1
Q

causes JIA

A
  • genetics
  • immune response
  • pro-inflammatory markers e.g. TNF
  • antibody presence
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2
Q

clinical presentation JIA

A
  • arthritis >6weeks
  • morning stiffness or gelling
  • irritability or refusal to walk in toddlers
  • school absence or limited ability to participate in physical activity
  • rash/ fever
  • fatigue
  • poor appetite
  • weight loss
  • delayed puberty
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3
Q

JIA differential diagnosis

A
  • septic arthritis
  • osteomyelitis
  • transient synovitis
  • malignancies
  • recurrent haemarthrosis
  • vascular abnormalities
  • trauma
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4
Q

JIA signs

A
  • swelling; soft tissue oedema/ intraarticular effusion
  • tenosynovitis
  • pain
  • joint held in position of max comfort
  • range of motion limited at extremes
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5
Q

criteria for psoriatic JIA

A

2/3 of:

  • dactylics (finger or toe inflammation)
  • onycholysis (nail pitting)
  • FH of psoriasis
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6
Q

criteria for enthesitis-related JIA

A

2/6 of:

  • HLAB27 positivity
  • acute anterior uveitis
  • inflammatory spinal pain
  • sacroiliac joint tenderness
  • FH of enthesisits related JIA
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7
Q

presentation systemic JIA

A
  • unwell
  • arthritis
  • intermittent fever >2 weeks
  • salmon pink erythematous rash
  • generalised lymphadenopathy
  • serositis
  • hepatomegaly/ splenomegaly
  • high inflammatory markers
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8
Q

JIA investigations

A
  • labs
  • plain x-ray
  • USS
  • MRI with contrast
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9
Q

pharmacological management JIA

A
  • NSAIDs
  • DMARDs
  • biologics
  • intra-articular and oral steroids
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10
Q

non-pharmacological management JIA

A
  • psychosocial factors
  • education adjustments
  • nutrition - address anaemia
  • physical therapy
  • OT
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11
Q

describe use of intraarticular steroids in JIA

A
  • highly effacious
  • remission >6months 84%
  • greater success in oligoarticular JIA
  • safe and effective
  • no long term side effects
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12
Q

describe use DMARDs JIA

A
  • methotrexate
  • should be used early for good outcome
  • most submit injection form
  • not many side effects
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13
Q

describe use biologic agents JIA

A
  • failure to respond to DMARDs
  • anti-TNF (e.g. infliximab)
  • good safety profile
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14
Q

presentation uveitis

A
  • history JIA
  • red eyes
  • headache
  • reduced vision
  • cataracts
  • glaucoma
  • blindness
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15
Q

what should all children diagnosed with JIA undergo screening for?

A

uveitis

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16
Q

management of uveitis

A
  • slit lamp exam
  • topical steroids intitially
  • more severe need systemic steroids
  • DMARD and biologics
17
Q

complications JIA

A
  • poor growth
  • localised growth disturbance
  • micrognathia
  • contractures
  • ocular complications

Paediatrics (23 decks)

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