A 7-year-old boy has been diagnosed with juvenile idiopathic ...

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A 7-year-old boy has been diagnosed with juvenile idiopathic arthritis (JIA), and his parents are anxious to know how his health problem will affect his short-term and longer-term future.
 
  What can his health care provider most accurately tell the family?
  A)
  Because JIA is an autoimmune disease, the long-term prognosis is quite poor and his mobility is likely to decline over time.
  B)
  The earlier that we can schedule joint replacement surgeries, the better his prognosis will be.
  C)
  With appropriate use of anti-inflammatory drugs along with lifestyle modifications, your son stands a good chance of leading a normal life.
  D)
  We can relieve many of the symptoms or JIA and ensure his mobility, but there is a risk he'll develop a systemic immune response beyond his joints.

Question 2

A 13-year-old girl and her father come in to the local health clinic hoping to see an orthopedic doctor about the girl's stiff and warm knee.
 
  The father reports that she hurt it sliding into base during a softball game, and the daughter concurs, but with further discussion, it becomes clear that the slide made an existing pain worse. Her knee had been stiff, warm, and shiny and had been keeping her awake at night for a week or so before the game. Which of the following might be the cause of the girl's symptoms?
  A)
  Osteosarcoma
  B)
  Osteoma
  C)
  Chondroma
  D)
  Osteochondroma

[juicepod]

Answer to Question 1

Ans:
C

Feedback:

NSAIDs, biologic response modifiers, and lifestyle modifications allow for a positive prognosis with most cases of JIA. Surgery is not necessarily indicated, and JIA is not noted to precipitate a systemic immune response.

Answer to Question 2

Ans:
A

Feedback:

Osteosarcoma is the most common bone tumor in children and the third most common cancer in children and adolescents; they most commonly arise in the vicinity of knee. The primary clinical feature of osteosarcoma is deep localized pain with nighttime awakening and swelling in the affected bone. Because the pain is often of sudden onset, patients and their families often associate the symptoms with recent trauma. The skin overlying the tumor may be warm, shiny, and stretched, with prominent superficial veins. The range of motion of the adjacent joint may be restricted. The four most common types of benign bone tumors are osteoma, chondroma, osteochondroma, and giant cell tumor; pain is a feature common to almost all malignant tumors but may or may not occur with benign tumors; pain that persists at night and is not relieved by rest suggests malignancy.