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58 Cards in this Set
- Front
- Back
IgA mediated vasculitis |
henoch schoenlein purpura |
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what precedes HSP |
URI (sometimes with prior GABHStrep infxn) |
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-petechia, palpable*purpura on BUTT* and LE* -edema -arthralgia/arthritis -colicky abd pain* -bloody stools* -hematuria* etc |
HSP |
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increased risk of _________ with HSP |
intussesception |
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what Ig levels are INCREASED* in HSP? |
IgA |
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petechia/purpura but patient has NORMAL plt count |
HSP |
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nonthrombocytopenic purpura |
HSP |
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Tx of HSP |
pain, hydration -steroids for abd pain & arthritis |
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acute febrile* vasculitis* |
kawaski |
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#1 cause acquired heart disease in kids |
kawasaki |
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age of kawasaki |
18-24 mo |
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fever >102 for longer than 5 days |
kawasaki |
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4/5 to dx kawasaki |
-conjunctivitis -oropharynx (red/cracked lips & strawberry* tongue) -cervical adenopathy (usually UNI) -rash (trunk and palms) |
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w/o for heart disease in kawasaki |
coronary artery aneurysms |
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kawasaki patient has acute RUQ pain |
hydrops of the gallbladder |
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3 phases of kawasaki |
acute: high ESR, high CRP subactue: high plt, decreasing esr/crp convalescent: normalized |
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Tx kawasaki |
IVIg with ASA*** |
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use of ASA in kawasaki |
acute phase: high dose ASA for anti-inflamm subacute phase: low dose ASA for antiplt effect |
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3 types of Juvenile arthritis |
1. pauciarticular (4 or less joints) 2. polyarticular (over 4 joints) 3. systemic (still's) |
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early-onset Pauciarticular JRA |
FEMALE, ANA, w/o: chronic uveitis* |
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late-onset Pauciarticular JRA |
MALE, HLA-B27*, hips/sacroiliac* |
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types of polyarticular JRA |
1. RF negative 2. RF positive (more severe) |
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high-spikig fevers in late afternoon/evening, joints, transient salmon* rash: fades with fevers, heaptosplenomegaly, LAD* |
systemic JRA |
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lab findings in JRA |
-microcytic anemia -ESR, CRP, PLT high |
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tx for JRA |
-NSAIDS -steroids/methotrxate/sulfasalazine |
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earliest age to get SLE |
10yo |
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lab finding in SLE that increases thrombotic events* |
antiphospholipid antibodies (lupus anticoagulant/anticardiolipin) |
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lab findings in SLE |
-low C3, C4 -antiSm antibodies -RF -ANA -anti-dsDNA |
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Tx for severe lupus NEPHRITIS* |
Cyclophosphamide* |
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Tx for thrombosis in SLE |
LMW heparin or warfarin |
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age for dermatomyositis |
5-14yo |
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lilac eyes, weeks later proximal muscle weakness |
dermatomyositis |
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calcinosis, nail bed telangiectasias |
dermatomyositis |
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labs in dermatomyositis |
increased creaetine phosphokinase , LDH, and other muscle enzymes |
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why is aspiration PNA common in dermatomyositis? |
d/t diminished gag reflex |
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Tx for dermatomyositis |
steroids (with vD) |
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NO risk of malignancy* with dermatomyositis |
only that way in adults |
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cause of rheumatic fever |
delayed, nonsuppurative, autoimmune complication of URI with GABHstrep (pyogenes) |
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what does rheumatic fever affect |
heart, vessels, joints, CNS, skin (inflammation of the connective tissues) |
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age of rheumatic fever |
5-15yo |
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major risk factor of rheumatic fever |
pharyngitis (NOT IMPETIGO******) |
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most common finding in rheumatic fever |
endocarditis (mitral & aortic) & myocarditis (lots of TACHY!!!!) |
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migratory, assymetric polyarthritis |
rheumatic fever (does not become chronic) |
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hand clumsiness, months after URI-->myocarditis/joints |
sydenham's chorea (from rehumatic fever) could lead to emotional lability |
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skin findings in rheumatic fever |
erythema marginatum (non itchy rash -with central clearing over trunk/limbs) & subcutaneous nodules |
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JONES criteria for rheumatic fever |
-migratory polyarthritis -carditis -sydenham's chorea -erythema marginatum -subQ nodules |
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Tx for rheumatic fever |
benzathine PCN* to IM injection (get rid of GABHS infx) & NSAIDS/steroids for inflammation |
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borrelia burgdoferi tick bite |
Lyme Dz |
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what is the vector for the borrelia spirochete? |
the ixodes deer tick |
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two stages of Lyme Dz |
1. early: erythema migrans rash with central clearing, constitutional Sx 1. early disseminated: could lead to aseptic meningitis*, facial nerve palsy*, encephalitis*, carditis with heart block* 2. late: ARthritIS***** |
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Dx Lyme Dz |
ELISA/Western blot for borrelia burgdorferi |
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Tx for early localized Lyme Dz or late dz (with arthritis ONLY*) |
Doxy*** (or amoxacillin) |
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Tx of carditis/meningitis* from Lyme Dz |
IV ceftriaxone or pcn |
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4 types of seronegative spondyloarthropathies |
1. Reactive arthritis (arthritis, urethritis, conjunctivitis from chalmydia*) 2. psoriatic arhtritis 3. ankylosing spondylitis (males with pauciarticular JrA, HLA-B27 will get this as adults) 4. arthritis with IBDz (HLA-B27, looks just like ankylosing spondylitis) |
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vasculitis affecting older kids and aneurysmal dilation/thrombosis* of aorta/carotid/Subclavian arteries |
takayasu |
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necrotizing granulomas in multiple organs (respiratory/kidnesy) with sinusitis*, hemoptosysi*, glomerulonepritis* |
wegener's granulomatosis |
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high titers of autoantibodies (ANA/RF) and connective tissue disease with Sicca* |
sjogrens |
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CREST: scleroderma but not as bad |
-calcinosis -raynauds -esophageal -skin sclerosis -telangiectasias |