rheumatology
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| must be < 16yoa and have symptoms for at least 6wks | diagnosis of JIA
🗑
|
||||
| what are the 3 types of JIA? | Systemic/oligoarthritis/polyarthritis
🗑
|
||||
| affecting 4 or fewer joints | oligoarthritis
🗑
|
||||
| morning stiffness that improves with movment later in the morning | JIA
🗑
|
||||
| leg-length discrepancies; enuresis may occur | JIA
🗑
|
||||
| requires daily fever occuring usually in the evenings | systemic JIA
🗑
|
||||
| when fever gone, child appears better; a/w arthalgias/myalgias | systemic JIA
🗑
|
||||
| peak age 5-10yrs; boys=girls | systemic JIA
🗑
|
||||
| mild rubbing/scratching of th skin may bring out the rash | kobner phenomenon
🗑
|
||||
| migratory rash, pink to salmon colored; uveitis is RARE | systemic JIA
🗑
|
||||
| on labs: leukocytosis, thrombocytosis, elevated ESR/CRP, anemia, RF & ANA negative | systemic JIA
🗑
|
||||
| elevated serum transaminases, D-dimer +, prolonged PTT, platelets & ESR drop precipitously, hemophagocytosis in bone marrow | macrophase activation syndrome
🗑
|
||||
| triggered by viruses, sulfa drugs, NSAIDS in systemic JIA | macrophage activation syndrome
🗑
|
||||
| age 1-7, ave is 5yoa; F:M is 3:1 | oligoarticular JIA
🗑
|
||||
| a/w positive ANA and asymptomatic UVEITIS | oligoarticular JIA
🗑
|
||||
| peak age is 1-3yrs(usu RF neg); adolescents can be RF positive | polyarticular JIA
🗑
|
||||
| if patient ANA positive and < 7yrs then need to screen for uveitis | polyarticular JIA
🗑
|
||||
| NSAIDS are first line for treatment | JIA
🗑
|
||||
| more severe disease can be treated by methotrexate | JIA
🗑
|
||||
| arthritis plus 2 of the following: dactylitis, nail findings and first degree relative with this dz | juvenile psoriatic arthritis
🗑
|
||||
| DIP joints commonly affected | juvenile psoriatic arthritis
🗑
|
||||
| can have uveitis and ANA positive, common in young girls or adoslecent boys | juvenile psoriatirc arthritis
🗑
|
||||
| this marker is common in ERA | HLA-B27
🗑
|
||||
| Name at least 2 other features a/w ERA (enthesitis) | sacroiliac joint tenderness; HLA-B27; 1st or 2nd degree relative w HLA-B27 dz; anterior uveitis; onset of arthrisi in a boy after 8yoa
🗑
|
||||
| pain in joints of lower extremities, low back and buttocks are commonly seen | ERA
🗑
|
||||
| triamcinolone joint injections if no improvement from NSAIDs | ERA treatment
🗑
|
||||
| arthritis flares occur with gut flares and improve with gut treatment | IBD associated arthopathy
🗑
|
||||
| typically occurs 1-4wks after GI infxn with yersenia, salmonella, or capylobacter or Chlamydia or ycoplasma | reactive arthritis
🗑
|
||||
| arthritis with conjunctivitis and uveitis | reactive arthritis
🗑
|
||||
| last 3-6wks, fever is common and it commonly affects large, weight bearing joints | reactive arthritis
🗑
|
||||
| borrelia burgdorferi | Lyme disease
🗑
|
||||
| Ixodes scapularis tick or Ixodes pacificus | Lyme disease
🗑
|
||||
| Erythema migrans | Lyme disease
🗑
|
||||
| Lyme disease - neurologics symptoms | peripheral neuropathy, bell's palsy, foot drop
🗑
|
||||
| DON'T do serology if suspecting this disease | Lyme disease
🗑
|
||||
| heart block is a later finding | lyme disease
🗑
|
||||
| treatment for lyme disease | doxycycline (x 2wks)
🗑
|
||||
| treatment for lyme carditis or meningitis | ceftriaxone
🗑
|
||||
| true or false: prophylaxis for hikers/campers is indicated | false
🗑
|
||||
| most commonly dx vasculitis of childhood | HSP
🗑
|
||||
| how does HSP occur? | IgA mediated
🗑
|
||||
| Name some HSP triggers | GABHS, Legionella, mycoplasma, yersinia, PCN, cephalosporins, MMR, yellow fever, food additives, insect bites
🗑
|
||||
| rash: small wheals or red maculopapules that become petechia and purpura on lower extremities and buttocks | HSP
🗑
|
||||
| may also see this classic rash (palpable purpura) on face and ears of young children | HSP
🗑
|
||||
| Name the 3 most common manifestations of HSP in order | 1. skin 2. joint 3. GI
🗑
|
||||
| which joints are commonly affected in HSP | large joints (periarthritis)
🗑
|
||||
| can result with ileoileal intussusception | HSP
🗑
|
||||
| can result with Hydrops gallbladder | HSP
🗑
|
||||
| what will you find on urine dip for HSP? | isolated microscopic hematuria/proteinuria
🗑
|
||||
| lab values for HSP | high WBC, ESR, IgA levels; Normal platelets and coagulation
🗑
|
||||
| How do you treat HSP | supportive
🗑
|
||||
| what is the likelihood of HSP reoccurance? | 40% from 6wks- 2yrs
🗑
|
||||
| "Pulmonary-renal" syndrome | Wegener granulomatosis
🗑
|
||||
| will have necrotizing granulomatous vasculitis of small vessels of the upper and lower respiratory tract and the kidney | Wegener granulomatosis
🗑
|
||||
| nasal deformity; c-ANCA positive | Wegener granulomatosis
🗑
|
||||
| how to acutely tx wegener's? | steroids, methotrexate, cyclophosphamide
🗑
|
||||
| what can you use to prevent relapse of Wegener's? | TMP/SMX
🗑
|
||||
| vasculitis of the arteries AND veins | Behcet disease
🗑
|
||||
| What is the classic triad of Behcet disease? | painful oral ulcers/painful genital ulcers/inflammatory eye disease
🗑
|
||||
| may commonly have erythema nodosum; pathergy | Behcet disease
🗑
|
||||
| Treatment for Behcet disease? | steroids, sometimes colchicine
🗑
|
||||
| Mean age for HSP | 4yrs; 75% under age 7
🗑
|
||||
| 20% of pediatric SLE is diagnosed under age? | 18
🗑
|
||||
| 2 most common labs in SLE | ANA and Anti ds-DNA
🗑
|
||||
| complement levels are high or low in SLE? | LOW
🗑
|
||||
| Classic xray findings of SLE | normal
🗑
|
||||
| type of arthritis of SLE | polyarticular of small and large joints
🗑
|
||||
| Skin manifestations of SLE | malar rash, discoid rash, photosensitivity, alopecia
🗑
|
||||
| CNS manifestations of SLE | seizures, CHOREA, cranial nerves, psychiatric disease
🗑
|
||||
| Hematologic manifestations of SLE | pancytopenia, coombs-positive hemolytic anemia, PT/PTT prolonged
🗑
|
||||
| Cardiac manifestations of SLE | pericarditis, Libman-Sacks endocarditis
🗑
|
||||
| Must have how many of the 11 criteria for diagnosis of SLE | 4 of 11
🗑
|
||||
| What are the diagnostic criteria for SLE | malar rash; discoid rash; photosensitivity; oral ulcers; arthritis; serositis; renal d/o; neurologic d/o; hematologic d/o; Immunologic d/o; positive ANA
🗑
|
||||
| How do you treat SLE? | Hydroxychloroquine for skin and joint flares (check eyes 1-2x/yr); azathioprine, cyclophosphamide; corticosteroids (flares)
🗑
|
||||
| Side effects of SLE meds | Avascular necrosis; osteoporosis; growth failure; glaucoma; DM; HTN; accelerated atherosclerosis
🗑
|
||||
| girls present with raynaud phenomenon, fever, arthritis, dorsal hand edema, rash and myositis | mixed connective tissue disease
🗑
|
||||
| over time, this disease acts more like scleroderma with esophageal disease and dysphagia | mixed connective tissue disease
🗑
|
||||
| Classic findings of sjogren syndrome | keratoconjunctivitis sicca; xerostomia; lyphocytic infiltrates on minor salviary gland bx; labs (one of the following: RF, ANA, Anti-Ro or Anti-La)
🗑
|
||||
| suspect this in children with recurrent parotitis and keratoconjunctivits sicca | sjogren syndrome
🗑
|
||||
| "bilateral evening or nighttime pains" | growing pains
🗑
|
||||
| heliotrope rash | juvenile dermatomyositis
🗑
|
||||
| autosomal recessive disorder; on chromosome 16 (regulates PMN inflammatory response) | familial mediterranean fever
🗑
|
||||
| presents before age 10yrs; fever cycles for 3-5 days/month | familial mediterranean fever
🗑
|
||||
| severe abdominal pain; pleuritis; pericarditis; scrotal swelling | familial mediterranean fever
🗑
|
||||
| how to treat familial mediterranean fever? | colchicine
🗑
|
||||
| 3 body areas of pain for at least 3 months | Fibromyalgia
🗑
|
||||
| stiffness in the morning, basically all day; all labs are normal | Fibromyalgia
🗑
|
||||
| can treat with amitriptyline or cyclobenzapine for nighttime sleep disturbances | Fibromyalgia
🗑
|
||||
| what does PFAPA stand for? | Periodic fever, aphthous-stomatitis; pharyngitis; cervical adenitis
🗑
|
||||
| this fever lasts for 5-7 days and stops by teenage yrs | PFAPA
🗑
|
||||
| can try cimetidine or tonsillectomy | PFAPA
🗑
|
||||
| swimming is good therapy; most commonly seen in girls | hypermobility syndrome
🗑
|
||||
| what to look for with hypermobility syndrome | marfan's, ehlers-danlos
🗑
|
||||
| most common cause of recurrent limb pain in children | growing pains
🗑
|
||||
| deep aching in non-articular areas (usually awaken from sleep) | growing pains
🗑
|
||||
| known as morphea; more common in children | Localized scleroderma
🗑
|
||||
| CREST syndrome | calcinosis; raynaud's; esophageal dysmotility; sclerodactyly; telangiectasias
🗑
|
||||
| more common in girls; rash with muscle weakness | juvenile dermatomyositis
🗑
|
||||
| gottron papules; treatment is prednisone | juvenile dermatomyositis
🗑
|
||||
| Which 2 cancers seen with Sjogren syndrome | MALT lymphoma and non-Hodgkin B-cell lymphoma
🗑
|
||||
| hypergammaglobulinemic purpura | sjogren syndrome
🗑
|
||||
| how to treat sjogren syndrome | artifical tears; antimalarial agents
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
fl_sun80
Popular Science sets