Rhumatology Flashcards
A 7-year-old with morning stiffness, knee and ankle swelling for 2months, ESR is normal, antinuclear antibody (ANA) 1:160
Oligoarticular juvenile idiopathic arthritis (JIA)
A 2-year-old female with recently diagnosed oligo JIA and positive ANA requires frequent screening for this comorbidity
Chronic anterior uveitis
Fatigue, weight loss, arthritis in multiple joints for >6weeks, positive RF, anti-cyclic citrullinated peptide antibodies present and ANA is negative
Polyarticular JIA
Fatigue, weight loss, no fever, arthritis in multiple joints, negative RF, ANA is positive
Polyarticular JIA with an increased risk of uveitis
A 5-year-old girl recently diagnosed with JIA, her ANA is positive; how frequently does she need screening for uveitis?
Every 3–4months (JIA,
A 9-year-old girl recently diagnosed with JIA, her ANA is positive, how frequently does she need screening for uveitis?
Every 6months (JIA, >7years and positive ANA)
An 8-year-old with knee pain for 6weeks, noted to have pain, swelling, decreased range of motion, difficulty bearing weight, synovial fluid shows decreased viscosity and WBC 15,000
Inflammatory arthritis
Fever, salmon-colored rash with fever and hot showers, arthritis in major joints, hepatosplenomegaly, leukocytosis, thrombocytosis, anemia of chronic disease, elevated ESR, negative RF, and negative ANA
Systemic JIA
Side effects include immunosuppression, adrenal suppression, weight gain, cushingoid facies, diabetes and acne
Corticosteroids
Child with systemic JIA presents with elevated liver enzymes, prolonged PTT, positive D-dimer, thrombocytopenia, hyperferritinemia, and low ESR
Macrophage activation syndrome
Malar rash, arthritis, proteinuria, leucopenia, thrombocytopenia, positive ANA, and anti-dsDNA
Systemic lupus erythematosus (SLE)
An African-American girl with pericarditis, pleurisy, recurrent oral ulcers, hemolytic anemia, and RBC casts in urine
SLE
This test is very sensitive but not specific for SLE
Antinuclear antibody (ANA)
Autoantibodies associated with arterial/venous thrombosis or recurrent miscarriage (in patients with or without SLE)
Antiphospholipid antibodies
The most severe type of lupus nephritis resulting in hematuria, proteinuria, elevated blood pressure and can lead to end-stage renal disease
Diffuse lupus nephritis (membranoproliferative, class IV)
Neonate born with heart block, annular erythematous plaques, anemia, thrombocytopenia, and elevated liver enzymes, positive SSA (Ro) and SSB (La) antibodies
Neonatal lupus