Pediatric Rheumatology

Question 0

Important to rule out if patient presents with monoarticular pain

Answer 0

Septic Arthritis (only emergency)

Question 1

Smaller joints (wrists) involvement would pint to?

Answer 1

Juvenile Idiopathic Arthritis (additional 4-6 weeks duration with more than 4 joints involved)
2-4 weeks with involvement of larger joints points to Rheumatic fever (RF)

Question 2

danger signs to look for in growing pains

Answer 2

systemic sx, persistent,progressing, unilateral pain, pain in the day, limitation of activity, SIGN OF ARTHRITIS, pain in the body

Question 3

Important requirement for the diagnosis of SLE based on SLICC classification

Answer 3

Requires 1 immunologic, 1 clinical criteria

Question 4

erytematous plaques with keratotic scaling or atrophic scarring at the back, ear and exposed areas

Answer 4

Discoid lesions

Question 5

Cutaneous reaction to light

Answer 5

Photosensitivity

Question 6

important to look in the oral cavity of SLE pts

Answer 6

oral ulcers

Question 7

Most freqiemt cardiac manifestatin in SLE

Answer 7

Pericarditis

Question 8

Best screening test for SLE

Answer 8

Anti-nuclear Antibodies (ANA) 95% sensitivity

Question 9

GI associations of SLE

Answer 9

Intestinal vasculitis, inc. Liver Function test

Question 10

classic feature of Arthritis in SLE

Answer 10

atleast two joints which are non-deforming

Question 11

SLE px with +antiphospholipid test are more prone to

Answer 11

vascular events- atherosclerosis,fetal loss

Question 12

major criteria for RF (jones criteria)

Answer 12

1 carditis
2 polyarthritis
3 syndenham chorea
4 erythema marginatum (like countries)
5 subcutaneous nodules (overlying bony prominences)

Question 13

diagnosis of rf

Answer 13

requirement:streptococcus infection (aso titers,ab,culture)
+ 2 major criteria

or
one major,one minor (arthralgia,fever,elevated esr,prolonged p-r on ecg)

Question 14

cut off age for JIA

Answer 14

16 years old

Question 15

used for the prognosis of pt with JIA

Answer 15

rheumatoid factor

Question 16

tetrad of symptoms of SLE

Answer 16

polyarthritis
palpable purpura
gi manifestations
glumeronephritis

Question 17

ophtalmic manifestations in kd vs measles

Answer 17

bulbar conjunctivitis for ophthalmic

measles: purulent discharge

Question 18

oromucosal manifestations: kd vs measles

Answer 18

vertical fissures,strawberry tomgue : kd

angular stomatitis, koplik’s spots: measles

Question 19

dermatological mx for kd vs measles

Answer 19

edema then desquamation is pathognomic for kd

angular fissurea,supportive : measles

Question 20

tx for kd and measles

Answer 20

IV Ig

Question 21

JUvenile dermatomyositis symptoms

Answer 21

heliotrope rash
gottron's papules
calcinosis
nailfold changes
muscle pain and proximal muscle weakness (gower's sign)

Question 22

laboratory work-ups( done only if 4 out of 5 mx satisfied) for jdm

Answer 22

elevated muscle enzymes
liver enzymes
emg-ncv
muscle biopsy

Question 23

facial hemiatrophy associated with localized scleroderma

Answer 23

parry romberg syndrome

Question 24

SLe differntiating mx

Answer 24

malar rash,oral sores

Question 25

rheumatic mx of common childhood diseases

Answer 25

oncologic,infectious,endocrine,psychogenic