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15 Cards in this Set
- Front
- Back
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A 7 year old girl has been complaining of pain & swelling of the left wrist & right knee off & onn for the past 3 months. She has been previously healthy. The pain is worse in the morning & improves throughout the day. Exam is remarkable for swelling & effusion of the right knee, with decreased range of motion
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JRA
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How does a pt with JRA present?
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1. morning stiffness, joint pain, & swelling
2. joint is warm & has decreased range of motion 3. ERYTHEMA Is RARE 4. LOW-grade fever may be present, as well as malaise |
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Describe Polyarticular JRA
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involves many small joints, especially the hands, & accounts for 35% of all JRA
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Describe Pauciarticular JRA
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affects fewer but LARGER joints in an asymmetric distribution
-risk for eye involvement = Iridocyclitis |
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Desribe Systemic JRA
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initial Extraauricular manifestations such as FEVER, RASH (especially w/ fever), hepatosplenomegaly, Pleuritis, & pericarditis
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What are the first-line drugs for JRA?
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Nonsteroidals including Aspirin
Methotrexate is 2nd line Antimalarials are occasionally used |
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What follow-up is extremely important in JRA?
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Ophthalmologic
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What are the characteristics of Kawasaki Disease?
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1. Fever is present in ALL cases...does not respond to antibiotics
2. Bilateral nonpurulent conjunctival injection 3. Mucus membrane changes = cracked lips, strawberry tongue 4. Peripheral extremitity changes = edema or erythema of hands or feet, periungual desquamation 5. Rash = truncal, polymorphous, nonvesicular 6. Cervical Lymphadenopathy |
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What is the treatment for Kawasaki disease?
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IVIG & high-dose Aspirin
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What 3 things can accompany Kawasaki disease?
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1. Thrombocytosis
2. Sterile pyuria 3. Anemia |
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A 5 year old boy is seen with maculopapular lesions on the legs & buttocks. He complains of ab pain. He has recently recovered from a viral URI. CBC, coagulation studies, & lytes are normal. Microscopic hematuria is present on urine analysis
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HSP = Anaphylactoid Purpura
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Define HSP
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IgA mediated vasculitis of small vessels & is the most common cause of nonthrombocytopenic purpura in children
Capillaries are most frequently involved |
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Describe the presentation of HSP
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-usually precedes URI
-Skin lesions are hallmark = start out as macule or wheal & blanch on pressure -> progress to petechiae -> vasculitis causes a palpable purpuric rash -rash typically on buttocks & legs -Edema & arthritis -GI symptoms = colicky pain, gross or occult blood in stool -Renal = hematuria, proteinuria, HTN -CNS rare but can have seizures |
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What is the therapy for HSP?
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Supportive = self-limited
Corticosteroids are used for GI & CNS complications |
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