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42 Cards in this Set
- Front
- Back
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name the number of joints involved with each prefix
mono oligo pauci extended pauci poly |
mono- one
oligo- 2-4 (3) pauci <5 extended pauci >5 poly 6+ |
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what is the usual age of onset for JIA?
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<9 yoa;
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females generally have more cases of arthritis except....
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in juvenile spondylitis and systemic JA
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16 yr old pt presents with knee pain that has been going on for 2 months, what must be on your ddx?
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JIA
age <17 arthritis 1 or + joints duration >6 weeks |
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what JIA dz looks like leukemia and infection?
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systemic
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3 yo pt presents with knees and elbows in pain for > 6 weeks + fever. DX
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systemic onset JIA
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what is the age range for growing pains?
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6-13
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where are the growing pains usually localized to?
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lower extremities and not joints (thighs, calves, and shins)
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when are growing pains most frequent?
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late in day or night
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what are the major features of Still's dz?
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also called systemic onset JIA
1) systemic signs and sxs 2) musculoskeletal sxs 3) usually <5 yoa 4) F=M < 5 yoa 5) F> M > 5 yoa |
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what are the 2 characteristics of systemic onset disease?
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high fever that oscillates during the day and hepatosplenomegally
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what does the JIA rash look like?
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evanescent, salmon pink, circumscribed macular, chest, axilla, thighs, and upper arms.
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what is unusual with JIA rash?
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it is non-pruritic
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what makes systemic onset disease look like leukemia?
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leukocytosis- 40,000 or higher
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ESR high, IgM RF- negative, ANA- negative, leukocytosis
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systemic onset disease
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what affect does age of the pt at onset have on their prognosis in systemic onset dz?
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younger the pt at onset, increased risk of poor health
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how do you manage systemic onset disease?
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splinting, PT and OT, NSAID, corticosteroids
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what are the three JIA subtype classifications?
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systemic onset, pauciarticular (+juvenile spondylitis), and polyarticular
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what are the general characteristics of pauciarticular onset disease?
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1) < 6yoa
2) F>M 3) <5 joints involved 4) most common (>50%) |
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what are the clinical features of pauciarticular disease subtype 1?
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- arthritis of 4 or + joints
- early growth abnormalities - risk of chronic uveitis w/in 5 yrs (asymptomatic) |
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what do you worry about in subtype 1 of the pauciarticular disease group when it comes to the epiphysis?
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discrepancies on their extremities length due to premature closing of the epiphysis
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female 3 yoa ANA +, RF - Dx? and what should be your next step?
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pauciarticular disease subtype 1
- rush this girl to the opthamologist to test for uveitis |
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what percentage of subtype 1 pauciarticular disease pts develop polyarthritis? anterior uveitis?
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poly- 20%
uveitis- 66% |
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what is the managment of pauciarticular disease subtype 1?
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splinting
pt and ot nsaids local corticosteroid injectiosn ? frequent ophthalmic assessments and tx |
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which pauciarticular disease subtype affects more men than women? how will they present?
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juvenile spondyloarthropathy
spinal dz of SI, lumbar, throacic and/ or cervical enthesopathies acute iritis |
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HLA-B27+, RF negative
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juvenile spondyloarthropathy
which is pauciarticular dz subtype II |
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how do you manage juvenile spondyloarthropathy?
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PT and OT
posture training NSAIDs anti-TNF agents****** local corticosteroid injecions hip arthroplasty ophth examination |
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what are the three subtypes of pauciarticular JIA? what are their age groups
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type 1: young = <6 yoa
type 2: juvenile spondyloarthropy = > 9 yoa type 3: Psoriatic = 8 yoa |
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what are the general characteristics of juvenile psoriatic arthritis?
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arthritis associated with psoriasis
-or arthritis assoc w/ * dactylitis * nail pitting * psoriatic rash * family hx of psoriasis (3 out of 4 for the starred ones) |
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what are the clinical features of juvenile psoriatic arthritis?
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asymmetric, flexor tenosynovitis, severe destructive arthritis (occas), and gen characteristics
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what is the #1 form of management of juvenile psoriatic arthritis?
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biologic agents (anti-TNF, IL-1ra)
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in polyarticular onset JRA what group is RF +? RF -?
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RF + = adolescent, severe, similar to adults
RF - = milder disease |
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what are the clinical features of polyarticular onset JRA RF negative?
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- can affect any joint
- reduced neck and TMJ ROM - flexor tenosynovitis - mild lymphadenopathy and hepatosplenomegally |
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Mild leukocytosis, RF negative, ANA occasionally positive
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polyarticular onset RF negative
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ANA +, RF Negative... what do you do?
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IMMEDIATELY TO THE OPTHAMOLOGIST!
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how do you manage Polyarticular onset? what is really important?
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spliting
PT/OT to maintain and improve joint and muscle fxn (REALLY IMPORTANT) NSAIDs DMARDs anti-TNF agents |
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what is the age of onset for polyarticular onset RF positive?
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>8 yoa
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what are the clinical features of polyarticular onset?
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polyarthritis of any joint, rheumatoid nodules
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what can X-rays show you for polyarticular onset RF positive?
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early erosive changes
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what is frequently positive for polyarticular onset RF positive?
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HLA-DRA
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what are the two most important ways to managed polyarticular onset RF positive?
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DMARDs, biologic agents
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what are the five txs approved by the FDA?
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NSAIDs, Gold, Sulfasalazine, Methotrexate, anti-TNF agents
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