Lesson 1: Kawasaki Disease

Question 1

Kawasaki Disease (DK), formerly know as _____________ on children especially younger than_______.

Answer 1

Kawasaki Disease (DK), formerly know as mucocutaneous lymph node syndrome on children especially younger than 5 years.

Question 2

KD is a ______ with a predilection for the _________.

Answer 2

KD is a vasculitis with a predilection for the coronary arteries.

Question 3

____________% untreated patients have coronary abnormalities , including aneurism.

Answer 3

20%-25% untreated patients have coronary abnormalities , including aneurism

Question 4

KD is the leading cause of ___________ in children in most developed countries ,including USA and Japan.

Answer 4

KD is the leading cause of acquired heart disease in children in most developed countries ,including USA and Japan.

Question 5

Etiology

• ________

Answer 5

Etiology

• Unknownetiology

Question 6

KD is a Vasculitis that predominantly affect the _________ , with a striking predilection for the _________.

Answer 6

KD is a Vasculitis that predominantly affect the medium size arteries , with a striking predilection for the coronary arteries.

Question 7

______ of endothelial and smooth muscle cell with intense inflammatory infiltration of the vascular

Answer 7

Edema of endothelial and smooth muscle cell with intense inflammatory infiltration of the vascular

Question 8

In the most severely affect vessels, involve _________ of the vascular wall

Answer 8

In the most severely affect vessels involve all 3 layers of the vascular wall

Question 9

The destruction of the _____________ result dilation(Ectasia)or saccular fusion aneurysm formation

Answer 9

The destruction of the internal elastic lamina result dilation(Ectasia)or saccular fusion aneurysm formation

Question 10

________may form in the lumen and obstruction blood flow

Answer 10

Thrombi may form in the lumen and obstruction blood flow

Question 11

Overtime the vascular wall can become ______ with marked intimal proliferation , producing arterial stenosis or occlusion

Answer 11

Overtime the vascular wall can become fibrotic with marked intimal proliferation , producing arterial stenosis or occlusion

Question 12

Clinical manifestation

High fever temperature 39-40C and unresponsive with __________.

Answer 12

Clinical manifestation

High fever temperature 39-40C and unresponsive with antibiotic

Question 13

Duration without treatment is generally ________ weeks but may persist for __________ weeks.

Answer 13

Duration without treatment is generally 1-2 weeks but may persist for 3-4 weeks.

Question 14

Inadditionoffeverneedmorefiveprincipalcriteria:(CRASH)

• __________withlimbalsparing
• ____ofvariousformwithaccentuationinthegroinarea.
• Nonsuppurative__________usuallyunilateral.
• Erythemaoftheoralandpharyngealmucosawith________anddrycreakedlips.
• Edemaanderythemaofthe_______and_______.

Answer 14

Inadditionoffeverneedmorefiveprincipalcriteria:(CRASH)

• Conjunctivalinjectionwithlimbalsparing
• Rashofvariousformwithaccentuationinthegroinarea.
• NonsuppurativecervicallymphAdenopathyusuallyunilateral.
• Erythemaoftheoralandpharyngealmucosawithstrawberrytongueanddrycreakedlips.
• Edemaanderythemaofthehandsandfeet.

Question 15

Associated symptoms other than the clinical criteria are common in the _____days prior to diagnosis of KD.

Answer 15

Associated symptoms other than the clinical criteria are common in the 10 day prior to diagnosis of KD.

Question 16

Gastrointestinal symptoms(vomiting diarrhea , or abdominal pain) occur in almost _________%.

Answer 16

Gastrointestinal symptoms(vomiting diarrhea , or abdominal pain) occur in almost 65%.

Question 17

Respiratory symptoms (interstitial infiltrates ,effusion) occur in ____________.

Answer 17

Respiratory symptoms (interstitial infiltrates ,effusion) occur in 30%.

Question 18

_______ involvement is the most important manifestation of KD

Answer 18

Cardiac involvement is the most important manifestation of KD

Question 19

_______ occur in most patients with acute KD and manifests as tachycardia __________ to fever along with diminish left ventricular systolic function.

Answer 19

Myocarditis occur in most patients with acute KD and manifests as tachycardia out of proportion to fever along with diminish left ventricular systolic function.

Question 20

_________ with a small pericardial effusion can also occur during in the acute illness

Answer 20

Pericarditis with a small pericardial effusion can also occur during in the acute illness

Question 21

Coronary artery aneurysm develop up to ________% of untreated patients in the second to third weeks of illness.

Answer 21

Coronary artery aneurysm develop up to 25% of untreated patients in the second to third weeks of illness.

Question 22

In the absence of treatment, KD can be divided into 3 clinical phase:

1. ______
2. _________
3. _______

Answer 22

In the absence of treatment, KD can be divided into 3 clinical phase:

1. The acute febrile phase
2. The sub acute phase
3. The convalescence phase

Question 23

The acute febrile phase: is characterized by _____ and the other acute signs of illness and usually last _____ weeks.

Answer 23

The acute febrile phase: is characterized by fever and the other acute signs of illness and usually last 1-2 weeks.

Question 24

The sub acute phase: is associated with ______ , _______ , the developments of coronary _____ and highest risk of ______and last about ______weeks.

Answer 24

The sub acute phase: is associated with desquamation , thrombocytosis , the developments of coronary aneurism and highest risk of sudden death and last about 2 weeks.

Question 25

The convalescence phase: began when all clinical signs of illness _____ and continue until the __________return to normal typically about ______ weeks after the onset of illness.

Answer 25

The convalescence phase: began when all clinical signs of illness disappeared and continue until the erythrocyte sedimentation rate return to normal typically about 6-8 weeks after the onset of illness.

Question 26

Diagnosis

Based on ________

Answer 26

Diagnosis

Based on clinical diagnosis

Question 27

The classic KD the diagnosis require the presence of ________ for at least_____days and at least ______ of five the other principal characteristic of the illness.

Answer 27

The classic KD the diagnosis require the presence of fever for at least 4 days and at least four of five the other principal characteristic of the illness.

Question 28

In atypical or incomplete KD, fever with ________of the five characteristic .In these patient ,laboratory and echocardiography can assist the diagnosis.

Answer 28

In atypical or incomplete KD, fever with less than four of the five characteristic .In these patient ,laboratory and echocardiography can assist the diagnosis.

Question 29

Differential diagnosis: 
\_\_\_\_\_\_infections
\_\_\_\_\_\_\_\_\_infection
\_\_\_\_\_\_\_\_\_ disease
Other
     - \_\_\_\_\_\_\_syndrome
    -  St\_\_\_\_\_\_\_\_\_\_\_\_\_skinsyndrome.
    - \_\_\_\_\_\_\_\_\_\_reactions.
    -S\_\_\_\_\_\_\_\_syndrome.

Answer 29

Differential diagnosis: 
Viral infections
Bacterial infection
Rheumatology disease
Other
     - Toxicshocksyndrome
    -  Staphylococcalscaldedskinsyndrome.
    - Drughypersensitivityreactions.
    -Steven–johnsonsyndrome.