A 15-year-old is diagnosed with severe Granulomatosis with Polyangiitis involving diffuse alveolar hemorrhage and crescentic glomerulonephritis. In addition to high-dose glucocorticoids, which of the following represents an appropriate first-line induction therapy for this life-threatening disease?
A mother with known anti-Ro (SSA) and anti-La (SSB) antibodies gives birth to a full-term infant. At 4 weeks of age, the infant develops an annular, erythematous rash on the scalp and around the eyes after sun exposure. The infant is otherwise well. Which of the following is the most accurate information to provide the mother regarding this condition?
A 14-year-old is being evaluated for multisystem complaints including a photosensitive rash, polyarthritis, and fatigue. The diagnostic workup for Systemic Lupus Erythematosus (SLE) includes serologic testing for various autoantibodies. The presence of which antibody is considered highly specific for a diagnosis of SLE?
The parents of a 12-year-old with chronic widespread pain are enrolled in a family-based psychological intervention. What is the primary rationale for including parents in the treatment plan for a child’s chronic pain syndrome?
You are evaluating two adolescents with ANCA-positive vasculitis and renal involvement. Patient A has significant destructive sinusitis and nasal crusting, while Patient B has no upper respiratory tract symptoms but has severe pulmonary hemorrhage. Patient B is more likely to have Microscopic Polyangiitis, which is pathologically distinguished from Granulomatosis with Polyangiitis by what feature?
A child with a known rheumatologic condition develops an acute episode of high fever, hepatosplenomegaly, and cytopenias. A diagnosis of Macrophage Activation Syndrome (MAS) is suspected. In which pediatric rheumatic disease is this life-threatening complication seen most frequently?
A 9-year-old boy is brought to the emergency department with a prominent rash on his legs and buttocks that developed over the past three days. The examination reveals a non-blanching, palpable purpuric rash located symmetrically on the extensor surfaces of his lower extremities. These findings are most characteristic of which condition?
A 16-year-old male with Behçet disease has refractory, painful oral ulcers despite topical therapies. You decide to start a systemic agent specifically noted to be effective for the oral ulcers of this condition. Which oral agent is an appropriate choice for this indication?
A resident is discussing the potential biologic basis of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) with an attending physician. Which of the following represents a leading hypothesis currently under investigation to explain the profound post-exertional malaise experienced by these patients?
The mother of a 6-year-old boy reports that he frequently wakes from sleep crying with severe, bilateral aching in his shins and thighs. She notes the pain often follows days with high physical activity and resolves completely by the next morning with massage. His physical exam is normal. Which diagnosis best fits this clinical picture?
