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Juvenile Rheumatoid Arthritis for USMLE
 
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Simple Explanation of Juvenile Rhumatoid Arthritis (JRA) for USMLE. Focusing on the Signs and Symptoms, clinical presentaiton, Diagnosis, Treatment and Management. In particular Oligoaruticular, Pauciarticular, Polyarticular, Systemic, Enthesitis and Psoriatic Arthritis. Juvenile Rheumatoid Arthritis is classified into 5 categories. The first category is oligoarticular or Pauci articular JA. Then there is polyarticular Juvenile Rheumatoid Arthritis. This is divided into subgroups depending on Rheumatoid Factor. Rhematoid Factor positive is also referred to as Early Onset Adult Rheumatoid Arthritis. Systemic Rheumatoid Arthritis, Enthesitis is not necessarily the joints but actually the tendon. Finally there is Psoriatic. Most common is oligoartiruclar (40%). RF postivie is more than RF-. Systemic 10-20% and the other is very rare. Oligoarticular Rhematoid Arthritis is when there is less than 4 joints within 6 months. If there is move than 4 joints, but takes longer than 6 months, then this is known as extended. This tends to be slightly more severe. Polyarticular is have more than 5 joints involved within 6 months. Systemic there is more than 5 jointsh within 6 months and there are systemic symptoms. Enthesitis is related to the tendon-bone attachment. FInally Psoriatic is related to a rash. Oligoarticular is less than 8 years, Rhematoid Factor Negative is found in 8-12 years old and Rheumatoid Factor Positive occurs in greater than 13 years old. Systemic can occur in any age group. Joints involved in Oligarticular hte knee is the most common, also affected is the ankle. Typically associated with morning stiffness and swollen joints. Hip involvement is unusual. Rhematoid Factor Negative Polyaritcular. Large and Small joints of hands and feets such as knee, ankles, and wrists. Temporomandivular joint and spine is also much more common joint. No HIP invovlement Rheumatoid Factor Positive is similar to Adult Rheumatoid Arthritis so it is symettrical and very aggressive. Systemic can be any joint. Enthesitis there is sacroiliac and spinal pain and stiffness Psoriatic is primarily Finger (Dactylitis) Uveitis is a very serious and common symptom. Oligoarticular Rheumatoid Arthritis can cause Iriditis. Also Enthesitis and Psoriatic which also has Anterior Uveitis. Psoriatic is painful whereas in Oligarticular is painless. Therefore you must do slit lamp to preven blindness, cataracts, glaucoma. Treatment with glucocorticoids and mydriatics. All of these are associated with ANA Positive. Rheumatoid Factor Negative does not have extra articular symptoms. However, in Rheumatoid Factor Positive there are classic Rheumatoid Nodules, vasculitis and lung disease and continue to adult Rheumatoid Arthritis. Systemic Rheumatoid Arthritis is difficult to diagnose because systemic symptoms may occur months before there are any joint involvement. The most important is associated with a fever and rash that goes away when there is fever. Salmon colored, erythematous and maculopapular. Serositis (pleuritis and Pericarditis lymphadenopathy and hepatosplenomegaly). There are some lab findings such as High ESR and elevated WBC and platelets. There is anemia and Elevated LFT. Macrophage Activating Syndrome (MAS). INcrease Macrophage, T Cell, Interferon Gamma, GM-CSF. You must rule out infection and malignancy. In Enthesitis there must be two of the following. First there must be sacroiliac tenderness and/or spinal pain. HLA B27, Family History if there is a history of primary or secondary relative. Associated Anterior Uveitis. Greater than 8 years old and if they are a boy. The prognosis of Enthesitis is good. Psoriatic Arthritis. Salmon colored lesion. It has a variable course with remissions and exacerbations. Diagnostic Criteria. Firstly, 6 weeks of persistent swollen joint. Must be less than 16 years old. Diagnosis of Exclusion so you must exclude septic arthritis. No test to rule out or confirm Juvenile Rheumatoid Arthritis therefore it is difficult to diagnose. Treatment is physiotherapy to maintain range of motion and avoid contractions. Multi-Discipline team effort of physiotherapist, social worker, orthopedic, ophthlamologist, Rheumatologist and possibly a pediatrician. Medications are NSAIDs and Intra-Articular corticosteroids and injections into joint that helps eliminate pain. Can't give for too long becuase it destroys the joint tissue. Disease Modifying Anti-Rheumatic Drugs. Methotrexate. Biologic Agents such as etanercepts, Adalimumab, Infliximab
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Caitlyn's Journey with JIA
 
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A toddler's journey with Juvenile Idiopathic Arthritis, systemic onset
Views: 2722 Michelle Cruz
Describe symptoms of Lyme disease arthritis
 
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Most patients who present with arthritis have oligoarticular inflammatory symptoms affecting one or more large joints. Most commonly the knee is involved. The arthritis can be migratory, but involvement of more than 5 joints is unusual.
Juvenile Idiopathic Arthritis: Clinical Guideline for Diagnosis and Management
 
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In Australia, at least 5,000 children are affected by Juvenile Idiopathic Arthritis JIA at any one time. The prevalence is between one and four cases per 1000 children. It is a chronic, autoimmune, inflammatory joint disease and the most common rheumatic disease in children and adolescents. JIA carries the potential for longer term inflammatory activity and complications, leaving a lasting impact on the child's function, growth and quality of life. Accurate and early diagnosis along with appropriate management and referral are essential for maximising patient outcomes and quality of life. With good treatment, most patients with JIA are able to lead an active life. Deaths due to JIA are rare, but the condition may have considerable effects on quality of life because of the psychological impact of long-term illness, the effects it imposes on family life and the side effects of medications used to treat it. It is important that children presenting with JIA are diagnosed early and GPs commence initial management and refer promptly to a paediatric rheumatologist. Because of the relatively low prevalence of JIA in the general population, GPs often have little experience with its diagnosis or management. Guidelines have been developed to fill that gap and reflect the current evidence based approach to managing children with JIA. This program covers the recommendations for the early diagnosis and multidisciplinary management of JIA in the primary care setting. It examines the practice points related to early identification, referral, prevention of complications, minimisation of pain and joint damage and improved quality of life. This program is one of four in the Musculoskeletal Guideline Series. The Royal Australian College of General Practitioners (RACGP) has developed national musculoskeletal clinical guidelines for general practitioners and other primary care health professionals for osteoarthritis, rheumatoid arthritis, juvenile idiopathic arthritis and osteoporosis. The guidelines are approved by the National Health and Medical Research Council (NHMRC). Produced by the Rural Health Education Foundation http://www.rhef.com.au/
Views: 1771 Rural Health Channel
Please help my child Zarina not to get blind
 
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Hi! My name is Raisa and I would like to introduce to you my daughter Zarina. She is seven. She was born absolutely healthy. In 2011 we unexpectedly got into hospital the diagnosis was rheumatoid idiopathic arthritis. This kind of disease causes the struggle of the body’s cells against its healthy ones. In 2015 her illness affected her eyes and as a result she got oligoarticular eye disease which means that my daughter can lose her eye–sight in every moment. The only medicine which relieves the sickness is Humira. This treatment is very expensive. Here in Kazakhstan it costs 1200 dollars per kit with two injections. 1 kit lasts 1 month. We need 24 kits. The sum is 28,800 $. In order to complete a minimum course of treatment (2 years) it’s necessary to have 24 boxes of a total value of $ 28 800. Funds for purchase the drug from the state budget is not allocated. In 2015 the medicine was provided by own budget of the local government only for 3 months of the treatment. At our own risk in order to save the drug we decided to share it with a child with the same disease. One injection was divided for two kids. As a result we have saved enough for 6 months. Government says that in 2016 there is no money in the budget to purchase the treatment for us. I appealed to the local executive bodies, in the largest party in Kazakhstan called "Nur Otan", and personally to the Minister of Health of the Republic of Kazakhstan. All of them understand our problem, but nobody can really help. They promise that perhaps the money will be allocated by the beginning of autumn. But it is not exact. The fact is that we cannot be provided with the drug continually. It depends on the budget. Now we are looking for charity and merciful people. Only because of you she can live her happy childish life. She is everything I have. Please give a chance to Zarina to pursue her dreams. https://igg.me/at/aaV4xpHgxpQ
Views: 93 Ruslan Ch
Psoriatic arthritis
 
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Views: 59 Wiki Health
Denise Connor, MD, Introduction to Clinical Reasoning
 
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Dr. Connor discusses the first of a series of workshops conducted to prepare students for their clinical microsystems clerkship. The clerkship augments the practice of history-taking and physical exams by engaging students with the entire context of care; it runs throughout the Foundations 1 block of the school's Bridges Curriculum. For more on Doctor Connor: http://profiles.ucsf.edu/denise.connor For a deep dive into Clinical Reasoning watch the videos by Dr. Catherine Lucey, the Vice Dean of Education: https://www.youtube.com/playlist?list=PLP08XsLK51Qxpz8Rp5hGH09_jTCBRoVAE UC San Francisco advances health through education, research, patient care and public service. With seven major sites in the San Francisco Bay Area and Fresno, the UCSF School of Medicine is dedicated to improving human health by accelerating scientific discovery and transforming medical education. The school’s new Bridges curriculum is pioneering a new approach to medical education to prepare physicians for practice in the 21st century. Through mentorship and collaborative learning, students are trained to care for patients, conduct research and contribute vital knowledge to improve our health system. Visit our channel home page: https://www.youtube.com/c/UCSFSchoolofMedicine Subscribe to this channel: https://www.youtube.com/channel/UCprcipiXNXTzJYJfN02rHsA?sub_confirmation=1
How to Pronounce Oligoarticular
 
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Learn how to say words in English correctly with Emma Saying free pronunciation tutorials. Over 140,000 words were already uploaded... Check them out! Visit my homepage: http://www.emmasaying.com
Views: 355 Emma Saying
How to Pronounce Oligoarthritis
 
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Learn how to say words in English correctly with Emma Saying free pronunciation tutorials. Over 140,000 words were already uploaded... Check them out! Visit my homepage: http://www.emmasaying.com
Views: 575 Emma Saying
How to Pronounce Spondyloarthropathy
 
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Learn how to say words in English correctly with Emma Saying free pronunciation tutorials. Over 140,000 words were already uploaded... Check them out! Visit my homepage: http://www.emmasaying.com
Views: 910 Emma Saying
דלקת מפרקים של גיל הילדות: תסמינים ודרכי אבחון
 
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דלקת מפרקים של גיל הילדות מלווה בתסמינים שונים המופיעים באופן שונה אצל כל ילד וילד. תסמינים אופייניים הנמשכים למעלה מ-6 שבועות יובילו לסדרת בדיקות אבחון שיאשרו האם מדובר ב-JIA. למחלה מגוון סוגים, כלומר תתי מחלה, הנקבעים לפי מאפייני החולה והמחלה: גיל, מיקום הדלקת, מספר מפרקים מעורבים ועוד. לכל תת מחלה מאפיינים, התנהלות ותסמינים שונים. קביעת סוג המחלה מסייעת לצפות את מהלכה, להבין את השלכותיה ולהתאים את הטיפול המיטבי. פרופ' ספי עוזיאל, מומחה לרפואת ילדים וראומטולוגיה ומנהל היחידה לראומטולוגיה ילדים ואשפוז יום ילדים במרכז הרפואי מאיר מסביר על המחלה ותסמיניה השונים ומפרט מהן הבדיקות הנחוצות לשם אבחונה. המרכז הרפואי מאיר: http://hospitals.clalit.co.il/hospitals/Meir קישורים מועילים: האגודה לזכויות החולה: http://www.patients-rights.org עמותת "מפרקים צעירים": http://www.mifrakim.org.il עמותת "עינבר": http://www.inbar.org.il * * * מטרתו של סרטון זה, מקצועי ככל שיהיה, הינה לספק מידע בלבד. הוא אינו מתיימר לשמש תחליף לאבחנה, לייעוץ פרטני או לטיפול רפואי מאת איש מקצוע מוסמך. המידע בסרטון מעודכן נכון לתאריך העלאתו לאתר. בנוסף, הוא עשוי לכלול תרגומים לשפות שונות, אלו עלולים לכלול טעויות תרגום. אין להתעלם מייעוץ רפואי פרטני, או לדחות טיפול וייעוץ רפואי, על סמך מידע אשר נצפה, נקרא או נשמע בסרטון זה. הסתמכות על מידע זה הינה באחריותכם בלבד.
Views: 2137 Doctors Channel