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14 Cards in this Set
- Front
- Back
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juvenile rheumatoid arthritis presentation
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morning stiffness
easy fatigability joint pain joint swelling warm joint but no redness <16 years old duration >= 6 weeks 3 types |
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juvenile rheumatoid arthritis differential
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SLE
rheumatic fever Lyme leukemia lymphoma juvenile dermatomyositis sarcoidosis scleroderma vasculitis psoriasis IBD |
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types of juvenile rheumatoid arthritis
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pauciarticular --> fewer than 5 joints
polyarticular --> >5 joints, resembles adult systemic --> hepatosplenomegaly, lymphadenopathy, serositis, iritis, temperature spikes, salmon-colored rash |
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juvenile rheumatoid arthritis diagnosis and labs
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diagnosis of exclusion
ANAs may be present RF(+) with polyarticular type |
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juvenile rheumatoid arthritis treatment
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pauciarticular --> NSAIDs +- methotrexate, sulfazalazine, azathioprine, cyclophosphamide
steroids if overwhelming inflammation and systemic illness opthalmologic follow-up |
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juvenile rheumatoid arthritis prognosis
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RF(+) --> poor prognosis
ANA(+) --> good/excellent prognosis |
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pregnant woman with SLE
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IgG are transferred transplacenta with permanent heart block in the fetus and other temporary findings
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SLE presentation
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usually after 8 years old
fever fatigue arthralgia malar rash anemia photosensitivity ANA(+) serositis discoid rash neurologic, hematologic, immunologic and renal disorders |
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SLE labs
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best screen --> ANA
best test --> anti-dsDNA (disease activity) most specific --> anti-Smith |
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SLE treatment
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NSAIDs if no renal disease
steroids for kidney disease hydroxychloroquine for mild disease cyclophosphamide for severe disease |
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kawasaki diagnostic criteria
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fever > 5 days plus 4 -->
bilateral conjunctivitis strawberry tongue erythema and swelling of hands and feet rash cervical lymphadenitis |
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kawasaki work-up
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upon suspicion --> echo for coronary artery aneurysms
reapeat echo at 2-3 weeks and if normal at 6-8 weeks CBC --> leukocytosis, thrombocytosis ESR PCR urinalysis --> sterile pyuria CSF pleocytosis |
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kawasaki treatment
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IV Ig
high-dose aspirin add warfarin if severe thrombocytosis |
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henoch-schonlein purpura
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low-grade fever
rash below waist --> maculopapular --> petechiae --> purpura GI pain, blood in stools, diarrhea, intuscuception glomerulonephritis increased IgA treatment --> symptomatic +- corticosteroids for GI +- aspirin APL antibodies |
