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Flashcards in peds46 Deck (24):
1

decreased complement (C3 and C4)

seen in active disease in SLE

2

diagnostic criteria for SLE (4 of 11 needed)

SOAP BRAIN MD; serositis, oral ulcers, arthritis, photosens, blood cytopenias, renal disease, ANA pos, immunoserology abnormalities, neuro, malar rash, discoid lupus

3

serositis

pleuritis or pericardial inflamm

4

immunoserology abnormalities in SLE

antibodies to DS DNA, Smith antigen, false pos RPR or VDRL assays

5

treatment of SLE

NSAIDs, immunosuppressants (glucocticoids are the mainstay of therapy; cyclophosphamide for severe lupus nephritis)

6

prognosis of SLE

survival over 90%; major causes of mortality are infection, renal failure, and CNS complications

7

dermatomyositis

infalmm of msucle results in progressive muscle weakness w characteristic skin findings

8

clincial features of dermatomyositis

constitutional sx; cutaneous findings in sun exposed areas, proximal muscle weakness

9

skin findings in dermatomyositis

periorbital vilaceous heliotrope rash; gottron's papules (skin over fingers may become erythematous and hypertrophic

10

proximal muscle weakness of dermatomyositis is in which joints?

hip girdle and legs; occurs weeks to months after eruption of skin findings

11

gower's sign in dermatomyositis

pos

12

diagnosis of dermatomyositis

classic clnical pres; abnormal EMG; abnormal muscle biopsy; incr muscle enzymes (CPK, etc.)

13

treatment of dermatomyositis

steroids, other immunosupp, vit D and calcium supp to decr fractures

14

complications of dermatomyositis

aspiration pneumonia due to diminishd gag reflex;intestinal perforation from GI vasculitis; osteopenia 2/2 steroids and muscle weakness

15

other manifestations of dermatomyositis

neck flexor muscle weakness, calcinosis, nail bed telangiectasias, constipation, dysphagia, cardiac involvement

16

prognosis for dermatomyositis

better in kids than adults;no association with malignancy in kids (though there is in adults); motality rate 3%

17

rheumatic fever

delayed autoimmune complication of URI with strep; characterized by inflamm of connective tissue

18

strep of strep throat

strep pyogenes; group A beta hemolytic

19

rheumatic fever most common in what age group?

5-15 yo

20

clinical features of rheumatic fever

cardiac involement, polyarthritis, sydenham's chorea, skin involvement

21

cardiac involvement in rheumatic fever

all layers of the heart; endocarditis is most common and causes insuff of the left sided valves; myocarditis manifested as tachycardia out of proportion to fever; pericarditis is less common

22

polarthritis in rheumatic fever

migratory, asymmetric, and exquisitely painful; does not result in chronic joint disease

23

sydenham's chorea in rheumatic fever

occurs months later; reflects involvement of the basal gang and caudate nuc involvement

24

skin involvement in rheumatic fever

erythema marginatum (nonpruritic rash); subcutaneous nodules on bony prominences of extensor surfaces of extremities