Kawasaki Disease Flashcards¶
Anki-compatible flashcards for Kawasaki Disease board review.
Q: What are the 5 principal clinical features of Kawasaki Disease (besides fever)? A: 1) Bilateral bulbar conjunctival injection (non-exudative), 2) Oral mucous membrane changes (strawberry tongue, cracked lips), 3) Peripheral extremity changes (edema, erythema, desquamation), 4) Polymorphous rash, 5) Cervical lymphadenopathy (≥1.5 cm, usually unilateral) Tags: kawasaki, diagnosis, criteria, high-yield
Q: What defines complete Kawasaki Disease? A: Fever ≥5 days PLUS ≥4 of 5 principal clinical features Tags: kawasaki, diagnosis, criteria
Q: What Z-score threshold defines a coronary artery aneurysm in Kawasaki Disease? A: Z-score ≥2.5 Tags: kawasaki, coronary, z-score, high-yield
Q: What is the first-line treatment for Kawasaki Disease? A: IVIG 2 g/kg as a single infusion over 10-12 hours PLUS high-dose aspirin (80-100 mg/kg/day divided QID) Tags: kawasaki, treatment, ivig, aspirin
Q: When should high-dose aspirin be transitioned to low-dose aspirin in Kawasaki Disease? A: After patient is afebrile for 48-72 hours Tags: kawasaki, treatment, aspirin
Q: What is the low-dose aspirin dose for Kawasaki Disease and how long should it continue? A: 3-5 mg/kg/day; continue for minimum 6-8 weeks (until confirmed no coronary artery abnormalities), or indefinitely if aneurysms present Tags: kawasaki, treatment, aspirin
Q: What defines a "giant" coronary artery aneurysm in Kawasaki Disease? A: Z-score ≥10 OR absolute dimension ≥8 mm Tags: kawasaki, coronary, aneurysm, high-yield
Q: Which patients with Kawasaki Disease are considered HIGH RISK and need treatment intensification? A: Z-score ≥2.5 at diagnosis, age <6 months, high Kobayashi score (Japan), or evidence of MAS Tags: kawasaki, risk-stratification, high-yield
Q: What is the treatment for IVIG-refractory Kawasaki Disease? A: Second dose of IVIG 2 g/kg, OR infliximab 5 mg/kg IV, OR methylprednisolone (2 mg/kg/day or 30 mg/kg pulse) Tags: kawasaki, treatment, refractory
Q: What long-term anticoagulation is recommended for giant aneurysms in Kawasaki Disease? A: Aspirin PLUS warfarin (target INR 2.0-3.0) OR aspirin plus LMWH Tags: kawasaki, anticoagulation, giant-aneurysm
Q: Which coronary arteries are most commonly affected in Kawasaki Disease? A: Proximal LAD (left anterior descending) and proximal RCA (right coronary artery) Tags: kawasaki, coronary, anatomy
Q: What cardiac complication can occur in the acute phase of Kawasaki Disease besides coronary aneurysms? A: Myocarditis (common, usually subclinical), pericarditis, valvular regurgitation (usually mitral), coronary artery ectasia Tags: kawasaki, complications
Q: At what intervals should echocardiograms be performed for Kawasaki Disease? A: At diagnosis, at 1-2 weeks, and at 4-6 weeks after treatment. More frequent if abnormalities detected. Tags: kawasaki, echo, follow-up
Q: What laboratory findings support the diagnosis of incomplete Kawasaki Disease? A: CRP ≥3 mg/dL AND/OR ESR ≥40 mm/hr, PLUS ≥3 of: Anemia for age, Platelet count ≥450,000 after day 7, Albumin ≤3 g/dL, Elevated ALT, WBC ≥15,000, Urine ≥10 WBC/hpf Tags: kawasaki, incomplete, diagnosis, labs
Q: What percentage of untreated Kawasaki Disease patients develop coronary artery aneurysms? A: 15-25% Tags: kawasaki, epidemiology, prognosis
Q: What percentage of Kawasaki Disease patients develop coronary abnormalities despite IVIG treatment? A: 2-5% Tags: kawasaki, epidemiology, prognosis
Q: What is the PHN Z-score classification for a coronary Z-score of 3.5 in Kawasaki Disease? A: Small aneurysm (Z-score 2.5 to <5.0) Tags: kawasaki, z-score, classification
Q: A 3-month-old infant has 6 days of fever, conjunctival injection, and irritability. CRP is 8 mg/dL. What should you do? A: Consider incomplete Kawasaki Disease; obtain echocardiogram and supplemental labs. Age <6 months is HIGH RISK - treat with IVIG if echo or labs supportive. Tags: kawasaki, incomplete, infant, clinical
Q: What activity restrictions apply to patients with giant coronary aneurysms from Kawasaki Disease? A: Avoid contact/collision sports and isometric exercise; stress testing before participation recommended; individualized based on functional status Tags: kawasaki, giant-aneurysm, activity, sports
Q: What is the most common cause of acquired heart disease in children in developed countries? A: Kawasaki Disease Tags: kawasaki, epidemiology, high-yield