Systemic JIA and Macrophage Activation Syndrome – Board-Style Questions

What this deck covers

Systemic JIA and macrophage activation syndrome 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. Up in the afternoon, down by night
2. A rash nobody can photograph
3. Fluid where it should not be
4. Numbers that all move the same way
5. Before the first dose
6. Which ones, and on both sides
7. Avoiding months of tablets
8. A child who changes overnight
9. The marker that goes the wrong way
10. What set it off
11. Drowsy, then a seizure
12. Two years of tablets
13. Breathless on the stairs
14. It never came back
15. Is it catching
16. Six quiet months
17. Why the usual tests are not sent
18. What decides how she does

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: A continuous fever that never returns to normal at any point, A drug reaction caused by the antipyretic she has been given, Bacterial infection of the sac, which requires urgent drainage, Intense systemic inflammation rather than bacterial sepsis, A repeat blood culture taken through a freshly placed needle, A single large joint, with every other joint in the body spared, A six-month course of daily corticosteroid tablets, Fibrinogen, triglycerides and liver enzymes urgently, The disease has responded very well to the treatment given, A rise in the dose of her regular treatment, Encephalopathy, which marks severe disease needing intensive care, Expected growth for a child of her age and sex, Asthma, which is common at this age and responds well to inhalers, A polycyclic course, with repeated and clearly separate flares.

Clinical pearls from this deck

• A daily peak with a well child between: quotidian fever.
• Fleeting pink rash with the fever peaks, provoked by heat.
• Positional chest pain and a rim of fluid: serositis.
• High neutrophils, high platelets, high ESR: fierce inflammation.
• Steroid before a marrow examination can mask a leukaemia.
• Symmetrical wrists and ankles, and a neck that will not turn.

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.