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39 Cards in this Set

  • Front
  • Back
Systemic IgA mediated vasculitis involving the skin, GI, kidneys
Henoch Schonlein Purpura
Henoch Schonlein Purpura
1. incidence/gender
2. presentation
3. stereotypical purpura occurence
4. Organs Affected (3)
5. Plt Count

1. median 5 yoa, male
2. viral/URI prodrome
3. buttocks and Lower Extrem.
4. Skin/GI/Renal
5. NOT Thrombocytopenic
Most common cause of acquired heart disease in children in US
Kawaski Dz (unknwon origin)
Kawaski Dz
1. incidence/Ethnic/Gender
2. Treatment
1. 18-24mo, Asia, Male
2. IVIG, ASA (high acute/low subacute)
What are the Diagnostic Criteria for Kawaski's Dz
1. Fever (>102) for >5d
2. 4/5 bilateral conjunctivitis nonexudative, oropharnygeal changes, cercial adenopathy, variable rash, changes in distal extremities (acute edema+induration, later peeling around nail bed)
3. Cannot be explained otherwise
2 Risk Factors of Kawaski Dz
Coronary Artery Aneurysm around 7-14 days (20%), Hydrops of gallbladder (10%)
Most common pediatric rheumatic disease with arthritis
Juvenile RA
1. onset/gender
2. Types (3)
1. 1-3yoa, females except systemic (even) or late onset pauciarticular (males)
2. Pauciarticular, Polyarticular, Systemic Onset
JRA Pauciarticular
1. early onset dxn (3)
2. late onset dxn
(<4 joints involved)
1. early onset: female, +ANA, risk for chronic uveitis
2. late onset: male, HLA-B27 +, hips and SI joint ivolved
JRA Polyarticular
1. subtypes
(> 4 joints involved)
1. Serum RF (+ more severe)
JRA Systemic Onset (Still's Disease)
High spiking fevers with nonpruritic evanescent salmon colored rash and ANA negative
4 Common skin findings in SLE
malar rash, photosensitive, alopecia, Raynaud's phenomenon
T/F - SLE often causes joint deformity or erosion.
Hematolic Manifestations of SLE.
leukopenia, thrombocytopenia, AOCD
3 Rheumatologic markers of SLE
1. ANA, 2.anti-dsDNA, 3.anti-Smith
Diagnostic Criteria for SLE
Serositis, Oral ulcers, Arthritis, Photosens., Blood cytopenias, Renal Dz, ANA +, Imunoserology abn, neurologic symp., malar rash, discoid lupus
1. incidence/gender
2. Cutaneous findings
3. Positive Clinical Sign?
4. Treatment
1. 5-14yoa/female
2. heliotrope periorbital rash and papules over knuckles
3. Gower's sign, climb up legs (proximal muscle weakness)
4. Corticosteroids are mainstay
T/F - There is no association with malignancy in pedaitric dermatomyositis.
T/F - The strains of streptococci that cause impetigo can not cause rheumatic fever
Endocarditis, most common finding of rheumatic fever, can cause insuffiency of the _.
Left sided valves
Describe the arthritis of rheumatic fever.
polyarthritis, migratory, asymmetric and exquistely painful but does not result in chronic joint dz
What skin Physical exam finding is associate with severe cardiac involvement in rheumatic disease?
subcutaneous nodules
Jones criteria for Rheumatic Fever
Evidence of recent strep infection and either 2 major or 1 major + 2 minor

1) migratory polyarthritis
3) sydenham's chorea
4) erythema marginatum
5) Subcutaneous nodules

1) Fever
2) Arthralgia
3) previous rh. fever
4) leukocytosis
5) elevated ESR or CRP
6) prolonged PR on ECG
Rheumatic Fever Treatment
1) Benzathine Penicillin IM (once) (OR) Pen Oral for 10 days
2) NSAIDs only AFTER diagnosis (masking)
3) Often Steroids
4) if chorea, haloperidol
5) if CHF, diuretic, salt restriction, digoxin
6) long term abx prophylaxis
Organism of Lyme Dz, vector
Borrelia burgdorferi via Ixodes scapularis (deer tick)
How long must the tick be on for lyme Dz to transmit?
36-48 hours
Describe the classic skin manifestation of Lyme Dz.
Erythema migrans which is annular and targetlike with central clearing
The cardio finding of lyme dz when found (rare)
heart block
Hallmark of late disease lyme disease
Laboratory test for lyme dz.
ELISA and Western blot
Treatment of Lyme Dz.
Arthritis only
1) doxycycline or amoxicillin

1)Ceftriaxone or Penicillin
Triad of Arthritis, Urethritis, and Conjunctivitis? Often triggered by _?
Reiter's Disease via Chlamydia
HLA B27 Male arthritis of LE and axial skeleton
Ankylosing spondylitis
Asian female with aneurysmal dilation or thrombosis of the large vessels, vasculitis
Takayasu's arteritis
Small-medium vessel sized aneurysms and thrombosis vascultis with skin manifestations
Polyarteritis nodosa
Granulomatis vasculitis affecting kidneys and lungs with sinusitis, hemoptysis and GN
Wegener's granulomatosis
Triad of Wegner'sq
sinusitis, hemoptysis and GN
Triad of Sjogren's Syndrome
Sicca (dry eyes/mouth), high autoABs, and CT dz
Define syndrome related to less extensive scleroderma
CREST: calcinosis, Raynaud's phenomenon, esophageal involvement, sclerosis, telangiectasias