Pediatrics Recalls By Subject – Rheumatology

A 15-year-old male arrives due to a rash on his face for the past two months
accompanied by muscle pain muscle weakness, pain and swelling in his right knee. Blood test results are described in the table:

Based on these data, what is the most likely diagnosis for this young man?

An 8-year-old boy presents with recurrent (6 up until now) of fever, abdominal and chest pain. The photo below reveals the finding on examination

Which of the following is a risk factor for complication in this disease?

A 5-year-old girl presents with severe abdominal pain and green vomitus. Examination reveals swelling
 of the knees and the rash in the picture 

Which of the following is true regarding long term follow-up?

A 5-year-old presents with a new limp, with no fever. The mother reports a febrile illness 10 days ago. Examination reveals he carries weight but limps on the right leg, and tenderness on right hip rotation. Laboratory tests are within the normal range. Hip sonography demonstrated a small amount of clear fluid with thickening of the synovia on the right hip joint.

Which of the following is the most recommended treatment?

A 4-year-old boy is referred due to a fever that has lasted for about two weeks, with a temperature of around 39°C every day. During this period the child has been complaining of pain in the knees and hands, also the mother mentions a rash on the back (see in the image) that appears intermittently. On his examination, there is evidence of arthritis in the wrists as well as in the knees.

Which of the following clinical findings will most likely accompany his illness?

A 6-year-old boy, normally healthy, was examined due to a rash in the shins and mainly in the area of the ankles and buttocks. The rash does not disappear when pressed and has a purplish color. Two days after the onset of the rash abdominal pain appeared. Blood pressure is normal, blood count is normal, chemistry panel is normal and on urinalysis, there is evidence of 30 red blood cells in the field of vision under the microscope. His complaints were resolved about a week later.

What would be the recommendation for the child at this stage?

An 18-months-old boy presents with 5 days of fever up to 38.4°C, and two days of non-purulent conjunctivitis and right cervical swelling. Examination reveals a restless baby, heart rate is 165 bpm, a disseminated macular rash, enlarged right cervical lymph node, about 2 cm, and tenderness in the abdominal right upper quadrant. Laboratory tests are attached.

Which of the following is the most important diagnostic test?

A 10-year-old female, usually healthy, was examined due to acute pain in her right calf that presented several days after being injured in her leg while playing with a ball. She continued playing after her injury. On examination – there was significant tenderness and pallor in the limb. Afebrile, no right calf swelling, no signs of contusion, no localized warmth. In laboratory tests – normal count and inflammatory markers are within normal range. Normal X-ray of the limb.

What would be the best treatment in this case?

A 4-year-old male complaining of abdominal and joint pain. On examination, a raised rash is observed (see image below). The parents reported rhinorrhea a week before his presentation. What is the most likely diagnosis?

A 5-year-old boy is referred for workup of a fever up to 39 oC, for the last 2 weeks. The fever is accompanied by limping and pain in the legs. The photos below show the physical findings.

Which of the following is typical for his most likely diagnosis?

A 16-year-old, generally healthy boy presents with fever, headaches, dyspnea, hemoptysis, malaise, and hematuria. Examination reveals he is pale, with respiratory rate of 24/min, bilateral lung rales with reduced breath sounds on the right, and sensitivity upon sinus percussion. No other abnormal findings.

Which of the following diagnostic tests will facilitate decisions regarding the most likely diagnosis?

18-month-old infant is evaluated due to fever for the past 6 days with erythema of the conjunctiva,

strawberry tongue, palmar edema, and lymphadenopathy. Labs- elevated CRP, anemia,

hypoalbuminemia. Echocardiography is normal. The patient is treated with IVIG.

Which of the following is a characteristic complication of the most likely diagnosis?

A 7-year-old boy is admitted due to fever of up to 39°C. The fever is daily for the past two weeks, mostly in the evenings (graph below).  On examination – hepatosplenomegaly and lymphadenopathy.
During fever spikes the following finding is noted that resolves when the fever normalizes.

Which of the following is the most appropriate treatment to his most likely diagnosis?

A 17-year-old boy is undergoing workup for abdominal pain. Laboratory results reveal positive, low titer anti-nuclear antibodies (ANA).
After a week the patient is well with no abdominal pain.

Which of the following represents correctly the significance of the blood test result for this patient?

A 5-year-old boy presents with an afebrile limp starting the day before. His mother reports a febrile illness 10 days earlier. On examination – he bares weight with a limp in his right leg, with tenderness upon right hip joint rotation.

Laboratory results include normal CPK and no leukocytosis. Hip joint ultrasound demonstrates a small amount of clear fluid on the right, and synovial thickening.

Which of the following is the most appropriate treatment?

A 14-year-old girl presents with 6 weeks of fatigue, weight loss, painless oral ulcers, and recurrent episodes of high fever. In addition, she reports intermittent left wrist and right knee pain. Her examination is significant for the finding in the picture.

Laboratory results are presented in the table:  

Which of the following is characteristic of the most likely diagnosis?

A 5-year-old male suffers from a fever of 39.5°C for the past 6 days, accompanied by enlarged lymph nodes, a maculopapular rash, eye discharge, and cracked lips. On examination, he is restless. Blood tests reveal elevated ESR and hypoalbuminemia.

What is the most correct treatment in this case?

An 8-year-old male has experienced fatigue and lower back pain following physical activity for the past year. Laboratory tests reveal normal levels of vitamin D, calcium, phosphorus, PTH and alkaline phosphatase. Bone density evaluation shows low bone mineral density. X-ray reveals a compression fracture of a lumbar vertebra.
What is the most likely diagnosis?

A 5-year-old girl is hospitalized with fever for the past two weeks, suspected systemic Juvenile idiopathic Arthritis. In the past two days her condition worsened, she appears sick, in her examination now, evidence of lymph nodes enlargement and also hepatosplenomegaly. The findings of the lab tests upon her hospitalization are described in Table 1.The findings of the lab tests taken upon the exacerbation of her condition are described in Table 2.

Which of the lab findings collected at the time of the exacerbation will support her likely diagnosis?

A 13-year-old girl complaining of intense pains in the left shin for the past 3 days. In anamnesis, about two weeks prior to her visit she injured her leg in a ballet lesson, and she continued dancing after the injury. Rules out systemic fever, notes sensation of paresthesia/tingling in the limb. Examination – significant tenderness over the left shin in mild touch, the limb is cold and pale. No limitation in joint movement. Lab tests are normal, including inflammatory indices, limb X-ray is normal.

Which of the following treatments is the most recommended based on the most likely diagnosis?