Juvenile Idiopathic Arthritis Flashcards
(22 cards)
Define JIA
Persistent joint swelling of >6weeks presenting before 16 years in the absence of infection or any other cause
Classification is based on x3
Rheummatoid factor
Systemic involvement - rash and fever
Number of joints affected in the first 6 months
History features characteristics x4
Gelling ie stiffness after period of inactivity
Avoidance of previously enjoyed activity
Morning joint stiffness and pain
Intermittent limping
Long term musculoskeletal effects of uncontrolled disease x3
Leg lengthening
Valgus deformity
Digit length discrepancy
Causes of joint swelling x5
Fluid
Inflammation
Chronic arthritis
Proliferation of the synovium
Swelling of periarticular soft tissues
What is an antinuclear antibody
Antibodies against self antigens
Complications of JIA x6
Growth failure
Chronic anterior uveitis
Flexion contractures
Delayed puberty
Amyloidosis
Anemia
What causes growth failure in patients with JIA x3
Anorexia
Chronic disease
Systemic steroid therapy
How does chronic anterior uveitis cause cataract x2 and glaucoma x2
Steroid use
Chronic inflammation
Why pts with oligoarticular disease are at greater risk of chronic anterior uveitis
Increased risk of association with rheumatoid factor
Causes of osteoporosis in JIA x4
Chronic steroid use
Decreased weight bearing
Diet - manage with vit D and calcium supplements
Delayed menarche - delays exposure to estrogen ie hormone importannt for bone growth
First line treatment for oligoarticular JIA x1
Methotrexate joint injections
Medical management during flares x2
NSAIDs
Analgesics
MOA of methotrexate in JIA
Medical management of JIA x5
NSAISs
Analgesics
Methotrexate
Corticosteroids
Cytokine modulators
Management of severe disease refractory to methotrexate
Cytokine modulators
Subtypes of JA (8)
Oligoarthritis persistent and oligoarthritis extended
Polyarthritis RF positive and RF negative
Systemic arthrits
Psoriatic arthritis
Undifferentiated arthrits
Enthesitis related arthritis
Presentation of SLE x3
Malaise
Athralgia
Photosensitive malar rash
What causes delayed puberty in JIA? x2
Cronic inflammation
Chronic steroid use
What is amyloidosis
Accumulation of amyloid protein in multiple organs
How does JIA cause anemia
Due to the state of chronic inflammation the body is not able to absorb iron and other nutrients necessary for RBC production
Supportive therapy in JIA x4
Physiotherapy
Ophthalmology
Orthopaedics
Dentistry
