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14 Cards in this Set

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juvenile rheumatoid arthritis presentation
morning stiffness
easy fatigability
joint pain
joint swelling
warm joint but no redness
<16 years old
duration >= 6 weeks
3 types
juvenile rheumatoid arthritis differential
SLE
rheumatic fever
Lyme
leukemia
lymphoma
juvenile dermatomyositis
sarcoidosis
scleroderma
vasculitis
psoriasis
IBD
types of juvenile rheumatoid arthritis
pauciarticular --> fewer than 5 joints
polyarticular --> >5 joints, resembles adult
systemic --> hepatosplenomegaly, lymphadenopathy, serositis, iritis, temperature spikes, salmon-colored rash
juvenile rheumatoid arthritis diagnosis and labs
diagnosis of exclusion
ANAs may be present
RF(+) with polyarticular type
juvenile rheumatoid arthritis treatment
pauciarticular --> NSAIDs +- methotrexate, sulfazalazine, azathioprine, cyclophosphamide
steroids if overwhelming inflammation and systemic illness
opthalmologic follow-up
juvenile rheumatoid arthritis prognosis
RF(+) --> poor prognosis
ANA(+) --> good/excellent prognosis
pregnant woman with SLE
IgG are transferred transplacenta with permanent heart block in the fetus and other temporary findings
SLE presentation
usually after 8 years old
fever
fatigue
arthralgia
malar rash
anemia
photosensitivity
ANA(+)
serositis
discoid rash
neurologic, hematologic, immunologic and renal disorders
SLE labs
best screen --> ANA
best test --> anti-dsDNA (disease activity)
most specific --> anti-Smith
SLE treatment
NSAIDs if no renal disease
steroids for kidney disease
hydroxychloroquine for mild disease
cyclophosphamide for severe disease
kawasaki diagnostic criteria
fever > 5 days plus 4 -->
bilateral conjunctivitis
strawberry tongue
erythema and swelling of hands and feet
rash
cervical lymphadenitis
kawasaki work-up
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
kawasaki treatment
IV Ig
high-dose aspirin
add warfarin if severe thrombocytosis
henoch-schonlein purpura
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