Peds Rheum

Question 1

What is the MC of childhood arthritis

Answer 1

Juvenile idiopathic/rheumatoid arthritis

Question 2

What is the diagnostic crieteria for JIA

Answer 2

6 wks and fever > 2 weeks, Morning stiffness

Question 3

Definition of arthritis

Answer 3

Limited ROM, tenderness, pain on motion or joint warmth – need 2

Question 4

What is the DDX of JIA

Answer 4

postinfectious arthritis, trauma, septic arthritis, childhood malignancies

Question 5

What are the subtypes of JIA

Answer 5

systemic, polyarticular, pauciarticular

Question 6

What is the peak age for onset of systemic JIA

Answer 6

1-6 yo

Question 7

What is a rare but poor prognostic factor of systemic JIA

Answer 7

uveitis

Question 8

presentation of systemic JIA

Answer 8

daily or 2xd fever spikes >101F, nonpruritic maculopapule rash, intermittent sx, fatigue, irritability, myalgia, general lymphadenopathy, HSM

Question 9

Lab findings of systemic JIA

Answer 9

ESR > 100, elevated ferritin, platelet counts increased, ANA and RF negative

Question 10

Complications of systemic JIA

Answer 10

pericardial tamponade, severe vasculitis with coagulopathy, macrophage activation syndrome

Question 11

What gender is more likely to develop polyarticular JIA

Answer 11

female

Question 12

presentation of RF + polyarticular JIA

Answer 12

girls > 8 yo, HLA-DR4+, 50% ANA +, 5% uveitis

Question 13

How often will a RF+ polyarticular JIA patient get a slit lamp exam

Answer 13

6 mos

Question 14

presentation of RF - polyarticular JIA

Answer 14

younger, nodules, low grade fever, 25% ANA +

Question 15

what percent of RF- polyarticular JIA patients develop into erosive arthritis

Answer 15

15%

Question 16

General presentation of pauciarticular JIA

Answer 16

_4 joints, absent systemic signs, RF -, large joints more often affected

Question 17

What is the most common joint affected in pauciarticular JIA

Answer 17

knee

Question 18

presentation of early onset pauciarticular JIA

Answer 18

1-5 yo, females, ANA+, eye inflammation, anterior chamber inflammation, severe eye disease if not treated

Question 19

Late onset presentation of pauciarticular JIA

Answer 19

boys, HLAB27+, enthesitis or tendonitis, large joints and spine affected, eye complications are RARE

Question 20

treatment of JIA

Answer 20

NSAIDs first line but may take a month to get affect, H2 blocker may be necessary, methotrexate if NSAIDs not enough

Question 21

How long does methtrexate take to be active in JIA

Answer 21

3-4 weeks for initial response, 3-6 mos for max response

Question 22

what other immunosuppressive meds are used in tx of JIA

Answer 22

sulfasalazine

Question 23

What med is reserved for severe complications of JIA

Answer 23

corticosteroids

Question 24

what is the mc of childhood vasculitis

Answer 24

henoch-schonlein purpura

Question 25

what gender is more commonly affected by henoch-schonlein purpura

Answer 25

males

Question 26

what other organ systems are involved in henoch schonlein purpura

Answer 26

GI and Kidney

Question 27

what is the most common precipitating factor of HSP

Answer 27

URI

Question 28

what immunoglobulin is thought to be involved in HSP

Answer 28

IgA

Question 29

What is the tetrad of HSP

Answer 29

palpable purpura, arthritis, abdominal pain, glomerulonephritis

Question 30

How long does the rash last in HSP

Answer 30

3 weeks

Question 31

What are GI complications that occur with HSP

Answer 31

ileocolic intussusception, pancreatitis, infarction, perforation, hydrops of the gallbladder

Question 32

What is the treatment of HSP

Answer 32

NSAIDs, self limited

Question 33

What arteries are mainly affected with Kawasaki Disease

Answer 33

coronary arteries

Question 34

What cells are elevated in Kawasaki Disease

Answer 34

T cells, B cells, monocytes and macrophage

Question 35

Presentation of Kawasaki Disease

Answer 35

first high fever (100-104 F), then rash, conjuctival injectin, oral mucosal changes

Question 36

How long will the fever last in Kawasaki Disease

Answer 36

5 days or more

Question 37

what are the mucous membrane changes in Kawasaki Disease

Answer 37

Diffuse injection or oral and pharyngeal mucosa, erythema or fissuring of lips and anus, strawberry tongue

Question 38

When will an aneurysm appear in Kawasaki Disease

Answer 38

boys, children

Question 39

What are the CNS manifestations of Kawasaki Disease

Answer 39

Aseptic meningitis, facial palsy, subdural effusion, cerebral infarction

Question 40

Treatment of Kawasaki Disease

Answer 40

flu shot, ASA, IVIG to reduce aneurysms, fever and inflammation

Question 41

What are the possible triggers of SLE

Answer 41

Genetics, Hormones, Environment, illness

Question 42

What is the criteria of SLE

Answer 42

Malar rash, oral ulcers, photosensitivity, arthritis, glomerulonephritis, thrombocytopenia, anti-DNA or Anti-Sm antibodies

Question 43

What test is used to evaluate SLE

Answer 43

anti-DNA and complement levels

Question 44

What test show an increased risk of thrombosis of SLE

Answer 44

antiphospholipid antibodies and lupus anticoagulant

Question 45

Treatment of SLE

Answer 45

Plaquenil, glucocorticoids, immunosuppresives

Question 46

What is the pathogen that causes Lyme Disease

Answer 46

Borrelia Burgdorferi

Question 47

What age group is Lyme Disease the most common

Answer 47

5-10 years

Question 48

What is the most common presentation of Lyme Disease

Answer 48

Erythema migrans within 1 month of infection

Question 49

What are the most common manifestations of early disseminated Lyme disease

Answer 49

cardiac and neurological disease

Question 50

What is the oral treatment for Lyme Disease

Answer 50

Doxy if >7 yo or Amoxicillin

Question 51

What is the IV therapy for Lyme Disease

Answer 51

Ceftriaxone or Cefotaxime