Pediatrics Brs Chapter 14

Front 1

Systemic IgA mediated vasculitis involving the skin, GI, kidneys

Back 1

Henoch Schonlein Purpura

Front 2

Henoch Schonlein Purpura
1. incidence/gender
2. presentation
3. stereotypical purpura occurence
4. Organs Affected (3)
5. Plt Count

4.

Back 2

1. median 5 yoa, male
2. viral/URI prodrome
3. buttocks and Lower Extrem.
4. Skin/GI/Renal
5. NOT Thrombocytopenic

Front 3

Most common cause of acquired heart disease in children in US

Back 3

Kawaski Dz (unknwon origin)

Front 4

Kawaski Dz
1. incidence/Ethnic/Gender
2. Treatment

Back 4

1. 18-24mo, Asia, Male
2. IVIG, ASA (high acute/low subacute)

Front 5

What are the Diagnostic Criteria for Kawaski's Dz

Back 5

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

Front 6

2 Risk Factors of Kawaski Dz

Back 6

Coronary Artery Aneurysm around 7-14 days (20%), Hydrops of gallbladder (10%)

Front 7

Most common pediatric rheumatic disease with arthritis

Back 7

Juvenile RA

Front 8

JRA
1. onset/gender
2. Types (3)

Back 8

1. 1-3yoa, females except systemic (even) or late onset pauciarticular (males)
2. Pauciarticular, Polyarticular, Systemic Onset

Front 9

JRA Pauciarticular
1. early onset dxn (3)
2. late onset dxn

Back 9

(<4 joints involved)
1. early onset: female, +ANA, risk for chronic uveitis
2. late onset: male, HLA-B27 +, hips and SI joint ivolved

Front 10

JRA Polyarticular
1. subtypes

Back 10

(> 4 joints involved)
1. Serum RF (+ more severe)

Front 11

JRA Systemic Onset (Still's Disease)

Back 11

High spiking fevers with nonpruritic evanescent salmon colored rash and ANA negative

Front 12

4 Common skin findings in SLE

Back 12

malar rash, photosensitive, alopecia, Raynaud's phenomenon

Front 13

T/F - SLE often causes joint deformity or erosion.

Back 13

False

Front 14

Hematolic Manifestations of SLE.

Back 14

leukopenia, thrombocytopenia, AOCD

Front 15

3 Rheumatologic markers of SLE

Back 15

1. ANA, 2.anti-dsDNA, 3.anti-Smith

Front 16

Diagnostic Criteria for SLE

Back 16

SOAP BRAIN MD
Serositis, Oral ulcers, Arthritis, Photosens., Blood cytopenias, Renal Dz, ANA +, Imunoserology abn, neurologic symp., malar rash, discoid lupus

Front 17

Dermatomyositis
1. incidence/gender
2. Cutaneous findings
3. Positive Clinical Sign?
4. Treatment

Back 17

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

Front 18

T/F - There is no association with malignancy in pedaitric dermatomyositis.

Back 18

True

Front 19

T/F - The strains of streptococci that cause impetigo can not cause rheumatic fever

Back 19

True

Front 20

Endocarditis, most common finding of rheumatic fever, can cause insuffiency of the _.

Back 20

Left sided valves

Front 21

Describe the arthritis of rheumatic fever.

Back 21

polyarthritis, migratory, asymmetric and exquistely painful but does not result in chronic joint dz

Front 22

What skin Physical exam finding is associate with severe cardiac involvement in rheumatic disease?

Back 22

subcutaneous nodules

Front 23

Jones criteria for Rheumatic Fever

Back 23

Evidence of recent strep infection and either 2 major or 1 major + 2 minor

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

Minor
1) Fever
2) Arthralgia
3) previous rh. fever
4) leukocytosis
5) elevated ESR or CRP
6) prolonged PR on ECG

Front 24

Rheumatic Fever Treatment

Back 24

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

Front 25

Organism of Lyme Dz, vector

Back 25

Borrelia burgdorferi via Ixodes scapularis (deer tick)

Front 26

How long must the tick be on for lyme Dz to transmit?

Back 26

36-48 hours

Front 27

Describe the classic skin manifestation of Lyme Dz.

Back 27

Erythema migrans which is annular and targetlike with central clearing

Front 28

The cardio finding of lyme dz when found (rare)

Back 28

heart block

Front 29

Hallmark of late disease lyme disease

Back 29

arthritis

Front 30

Laboratory test for lyme dz.

Back 30

ELISA and Western blot

Front 31

Treatment of Lyme Dz.

Back 31

Arthritis only
1) doxycycline or amoxicillin

Carditis/Meningitis
1)Ceftriaxone or Penicillin

Front 32

Triad of Arthritis, Urethritis, and Conjunctivitis? Often triggered by _?

Back 32

Reiter's Disease via Chlamydia

Front 33

HLA B27 Male arthritis of LE and axial skeleton

Back 33

Ankylosing spondylitis

Front 34

Asian female with aneurysmal dilation or thrombosis of the large vessels, vasculitis

Back 34

Takayasu's arteritis

Front 35

Small-medium vessel sized aneurysms and thrombosis vascultis with skin manifestations

Back 35

Polyarteritis nodosa

Front 36

Granulomatis vasculitis affecting kidneys and lungs with sinusitis, hemoptysis and GN

Back 36

Wegener's granulomatosis

Front 37

Triad of Wegner'sq

Back 37

sinusitis, hemoptysis and GN

Front 38

Triad of Sjogren's Syndrome

Back 38

Sicca (dry eyes/mouth), high autoABs, and CT dz

Front 39

Define syndrome related to less extensive scleroderma

Back 39

CREST: calcinosis, Raynaud's phenomenon, esophageal involvement, sclerosis, telangiectasias