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58 Cards in this Set

  • Front
  • Back

IgA mediated vasculitis

henoch schoenlein purpura

what precedes HSP

URI (sometimes with prior GABHStrep infxn)

-petechia, palpable*purpura on BUTT* and LE*


-edema


-arthralgia/arthritis


-colicky abd pain*


-bloody stools*


-hematuria* etc

HSP

increased risk of _________ with HSP

intussesception

what Ig levels are INCREASED* in HSP?

IgA

petechia/purpura but patient has NORMAL plt count

HSP

nonthrombocytopenic purpura

HSP

Tx of HSP

pain, hydration


-steroids for abd pain & arthritis

acute febrile* vasculitis*

kawaski

#1 cause acquired heart disease in kids

kawasaki

age of kawasaki

18-24 mo

fever >102 for longer than 5 days

kawasaki

4/5 to dx kawasaki

-conjunctivitis


-oropharynx (red/cracked lips & strawberry* tongue)


-cervical adenopathy (usually UNI)


-rash (trunk and palms)

w/o for heart disease in kawasaki

coronary artery aneurysms

kawasaki patient has acute RUQ pain

hydrops of the gallbladder

3 phases of kawasaki

acute: high ESR, high CRP


subactue: high plt, decreasing esr/crp


convalescent: normalized

Tx kawasaki

IVIg with ASA***

use of ASA in kawasaki

acute phase: high dose ASA for anti-inflamm


subacute phase: low dose ASA for antiplt effect

3 types of Juvenile arthritis

1. pauciarticular (4 or less joints)


2. polyarticular (over 4 joints)


3. systemic (still's)

early-onset Pauciarticular JRA

FEMALE, ANA, w/o: chronic uveitis*

late-onset Pauciarticular JRA

MALE, HLA-B27*, hips/sacroiliac*

types of polyarticular JRA

1. RF negative


2. RF positive (more severe)

high-spikig fevers in late afternoon/evening, joints, transient salmon* rash: fades with fevers, heaptosplenomegaly, LAD*

systemic JRA

lab findings in JRA

-microcytic anemia


-ESR, CRP, PLT high

tx for JRA

-NSAIDS


-steroids/methotrxate/sulfasalazine

earliest age to get SLE

10yo

lab finding in SLE that increases thrombotic events*

antiphospholipid antibodies (lupus anticoagulant/anticardiolipin)

lab findings in SLE

-low C3, C4


-antiSm antibodies


-RF


-ANA


-anti-dsDNA

Tx for severe lupus NEPHRITIS*

Cyclophosphamide*

Tx for thrombosis in SLE

LMW heparin or warfarin

age for dermatomyositis

5-14yo

lilac eyes, weeks later proximal muscle weakness

dermatomyositis

calcinosis, nail bed telangiectasias

dermatomyositis

labs in dermatomyositis

increased creaetine phosphokinase , LDH, and other muscle enzymes

why is aspiration PNA common in dermatomyositis?

d/t diminished gag reflex

Tx for dermatomyositis

steroids (with vD)

NO risk of malignancy* with dermatomyositis

only that way in adults

cause of rheumatic fever

delayed, nonsuppurative, autoimmune complication of URI with GABHstrep (pyogenes)

what does rheumatic fever affect

heart, vessels, joints, CNS, skin (inflammation of the connective tissues)

age of rheumatic fever

5-15yo

major risk factor of rheumatic fever

pharyngitis (NOT IMPETIGO******)

most common finding in rheumatic fever

endocarditis (mitral & aortic) & myocarditis (lots of TACHY!!!!)

migratory, assymetric polyarthritis

rheumatic fever (does not become chronic)

hand clumsiness, months after URI-->myocarditis/joints

sydenham's chorea (from rehumatic fever) could lead to emotional lability

skin findings in rheumatic fever

erythema marginatum (non itchy rash -with central clearing over trunk/limbs) & subcutaneous nodules

JONES criteria for rheumatic fever

-migratory polyarthritis


-carditis


-sydenham's chorea


-erythema marginatum


-subQ nodules

Tx for rheumatic fever

benzathine PCN* to IM injection (get rid of GABHS infx) & NSAIDS/steroids for inflammation

borrelia burgdoferi tick bite

Lyme Dz

what is the vector for the borrelia spirochete?

the ixodes deer tick

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*****

Dx Lyme Dz

ELISA/Western blot for borrelia burgdorferi

Tx for early localized Lyme Dz or late dz (with arthritis ONLY*)

Doxy*** (or amoxacillin)

Tx of carditis/meningitis* from Lyme Dz

IV ceftriaxone or pcn

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)

vasculitis affecting older kids and aneurysmal dilation/thrombosis* of aorta/carotid/Subclavian arteries

takayasu

necrotizing granulomas in multiple organs (respiratory/kidnesy) with sinusitis*, hemoptosysi*, glomerulonepritis*

wegener's granulomatosis

high titers of autoantibodies (ANA/RF) and connective tissue disease with Sicca*

sjogrens

CREST: scleroderma but not as bad

-calcinosis


-raynauds


-esophageal


-skin sclerosis


-telangiectasias