1JIA is a diagnosis of
exclusion
2Patients with systemic juvenile idiopathic athritis (sJIA) can have
fevers
rashes
increase WBC count
anemia
elevated acute phase reactances
lymphadenopathy
hepatosplemonmegaly
pericarditis
3How is the correct diagnosis of sJIA usually made?
patient given ATBX for a infection and they have no response
malignancy is excluded
4What is the peak onset for SJIA?
1-5 years old
5What is common early on in the course of sJIA?
arthralgias
6In sJIA (compared to other JIA subtypes) where can pain start?
hips
7What other joints are commonly involved in sJIA?
wrists
knees
ankles
8What would put a diagnosis of sJIA in doubt?
if the patient's temperate did not return to normal on a daily basis
9The fever for sJIA must spike to ___ degrees celcius on a daily basis. This is call ___ fever
38.5
quotidian
10What does the rash look like with sJIA and what is the pattern?
evanescent, macular, salmon pink
fleeting (goes away or lightens when the patients temp goes down)
11What does lymph node biopsy show for sJIA?
benign reactive hyperplasia
12What is commonly seen with adult onset stills disease and not commonly found in sJIA?
pharyngitis
13JIA is a diagnosis of
exclusion
14What is the most common subgroup of JIA?
oigoarticular
15Which oligoarthritis involves no more than 4 joints involved for 6 months who never develop to 5 or more joints during disease course?
persistent
16Which oligoarthritis refers to children with less than five joints affected during the first 6 months but eventually experience involvment in more than 4 joints?
extended
17What joints are commonly effects with oligoarticular JIA?
knees
ankles
wrists
elbows
18Which joint is never or rarely effected with oligoarticular or polygoarticular JIA?
hips
19What systemic manifestation is present with oJIA?
uveitis
20Joints effected with oJIA present as
swollen
tender
warm
21What is often absent in joints affected by oJIA?
erythema
22What are the two most common long term complications of oJIA?
uveitis
leg length discrepancy
23What is the criteria for oJIA?
4 or less joints effects for 6 months
ESR greater than 40
Hgb less than 11 (anemia)
24Patient with high ESR and anemia are more likely to develop?
extended oligoarticular JIA
25What commonly causes infectious myositis?
viral infections
26Oligoarticular arthritis is a common late manifestation of
lyme disease
27What should you do to r/o lyme disease?
ELISA for screening
western blot for confirmation
28What is an important hx question to ask patients who you suspect may have oligoarticular JIA?
any family hx of IBD
poor weight gain
history of loose stools/diarrhea
29What should raise your suspicion for malignancy over oligoarticular JIA?
night sweats
periarticular pain
hip involvement
30What is the hallmark for juvenile dermatomyositis and polymyositis?
muscle weakness
31Patients with JDM and JPM may also have
fever
weight loss
fatigue
h/a
32What is a heliotrope rash?
heliotrope discoloration of the eyelids and malar or facial erythema
33What is gottron's rash?
scaly red rash on the kucks with gottron papules
34Which rash is more common with JDM?
gottron's
35What are the five critera for JDM and JPM?
symmetric weakness of the proximal muscles
characteristic cutaneous changes (heliotrope and gattron)
elevation of the serum level of one of the muscle enzymes
EMG demonstrating denervation and myopathy
muscle biopsy displaying necrosis and inflammation
36How many criteria do you need to meet for a probable diagnosis vs definitive?
probable-3
definative-4
37What distinguishes infectious myositis from JDM and JPM?
recent history of an illness
no rash
calf pain instead of proximal muscle weakness
38What commonly causes infectious myositis?
viral infections