Facts and Features
The classic description of a KD patient's tongue
The incidence of KD is greatest in children living in East Asia, particularly Japan.
What is True
The most common organ system for complications of KD
What is the cardiovascular system
Animal that gnaws down trees and the finding a pt must have ≥5 days for KD
What is beaver fever
A throat swab may differentiate this acute illness from KD, while both dx can have fever, oral mucosa findings, and rash with desquamation
Streptococcal Scarlet Fever
KD is more common in females than males
What is False
Male:Female is 1.5:1
This is obtained at 1-2 weeks and 4-6 weeks after discharge
ECHO
The most important imaging to get with suspected KD and a lizard with sticky feet
What is ECHO gecko
KD is a systemic illness of this type within the body
What is systemic vasculitis
Cervical lymphadenopathy is present in >90% of KD patients
What is False
Cervical lymphadenopathy is present in 25-70% of cases, making it the lease reliable finding associated with the disease
This complication is the principal cause of KD mortality, with the highest risk in the first 6-12 months
What is MI
Treatment for KD and a shopping frenzy
What is IVIG spree
>90% of patients with KD have this ocular finding
What is bilateral conjunctivitis
High dose aspirin reduces the development of coronary aneurysms
What is false
ASA is believed to modify the inflammatory state and prevent thrombosis, but does not appear to impact the development of coronary aneurysms
Name 2 risk factors associated with coronary artery abnormalities as a KD complication
Late dx or delayed IVIG administration
Age <1 year or >9 years
Male
Fever ≥ 14 days
Labs: low Hct, low albumin, low sodium elevated liver enzymes, elevated ESR/CRP, elevated WBC
A lively style of dance popular especially in the 1940s and 1950s and 80-90% of KD cases occur in children younger than this age
What is Jive Five
This platelet abnormality is a common laboratory finding in KD pts
What is thrombocytosis
Reactive thrombocytosis up to 1,000,000 can be reached in severe cases. Rarely KD pts can develop thrombocytopenia due to consumptive coagulopathy.
If a coronary aneurysm is present, regular stress testing to assess for inducible myocardial ischemia is indicated
What is True
Assessment for inducible myocardial ischemia with stress testing is indicated ranging from every 6 months to every 5 years if an aneurysm is present, depending on the aneurysm status and size
This uncommon presentation of KD occurs in <10% of cases and typically includes elevated troponin, hyponatremia, elevated LA, and coagulopathy. It can be life threatening
What is KD shock syndrome (KDSS)
Other typical lab findings of KDSS include thrombocytosis (or thrombocytopenia), elevated D-dimer, elevated ESR/CRP, elevated hepatic enzymes
Recovery (convalescent) phase KD finding of the hands and feet and a very important, public announcement
What is desquamation proclamation
Name the 5 physical findings that make up the diagnostic criteria in addition to the fever
- Bilateral bulbar conjunctival injection
- Oral mucous membrane changes (strawberry tongue, injected/fissured lips, injected pharynx)
- Peripheral extremity changes (edema, erythema, desquamation)
- Polymorphous rash
- Cervical lympphadenopathy (at least one >1.5 cm)