Juvenile Dermatomyositis – Board-Style Questions

What this deck covers

Juvenile dermatomyositis in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Scaly patches on the knuckles
2. A purple tinge above the eyes
3. Cannot get up off the floor
4. Reassured by the enzyme
5. What the scan shows
6. Looking at the cuticles
7. Do we need a piece of it
8. Coughing at mealtimes
9. Abdominal pain and a dark stool
10. Two drugs, not one
11. The rash that outlasts the weakness
12. Hard lumps under the skin
13. One result that changes the watch
14. Losing the fat from her face
15. Putting a number on it
16. Sore calves after the flu
17. How long will this go on
18. Will she run again

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Gottron papules, which are highly specific for this illness, Periorbital cellulitis in its earliest stage of development, Distal weakness of the hands and the feet, A normal enzyme excludes muscle disease altogether, Complete replacement of the muscle bulk by fat and fibrous tissue, Vasculopathy, and they track how active it is, It is required in every child before treatment begins, A viral infection affecting his throat and his voice, A duodenal ulcer caused by the tablets she takes, A short course of steroid alone, then observation, A potent topical steroid applied twice each day, Calcinosis, which follows late or inadequate treatment, Rheumatoid factor, which predicts erosion of the joints, Simple weight loss from a poor appetite during treatment.

Clinical pearls from this deck

• Violaceous papules over the knuckles: the most specific sign.
• Violet, swollen upper lids with weakness: a classical rash.
• Stairs, arms overhead and rising from the floor: girdle weakness.
• Normal muscle enzymes do not let you off the diagnosis.
• The scan lights up muscle, fascia and the fat beneath.
• Widened and missing vessels at the nail fold: vasculopathy.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all rheumatology and immunology case decks · pediatric reference values.