Source / episode info

• **Episode:**94
• **Title:**Divine Intervention Episode 94 – USMLE Step 2CK Rapid Review Series 1 (Peds)
• **Published:**2019-04-20
• Source:Episode page

One-liner

This rapid review emphasizes key pediatric diagnoses including Kawasaki disease and Henoch-Schönlein purpura; differentiating JIA subtypes (oligoarticular vs polyarticular); recognizing age-specific hip pathologies (LCP vs SCFE); mastering the clinical signs of upper versus lower airway obstruction (Croup/Epiglottitis/Bronchiolitis); and outlining the stepwise management of pediatric asthma.

High-yield summary

• Kawasaki Disease: Requires fever > 5 days plus at least four of five criteria (conjunctivitis, rash, extremity changes, oral changes, lymphadenopathy). Classic complications include coronary artery aneurysms; treatment is Aspirin and IVIG.
• Henoch-Schönlein Purpura (HSP): A systemic vasculitis characterized by the classic triad of palpable purpura (non-thrombocytopenic), arthritis/arthralgia, and abdominal pain. It is a high-yield manifestation of IgA nephropathy.
• Airway Obstruction Differentiation: Croup (Laryngotracheobronchitis) presents with inspiratory stridor and the "steeple sign" on X-ray; Epiglottitis presents with severe toxicity, drooling, and a "thumbprint sign"; Bronchiolitis typically causes expiratory wheezing.
• JIA Classification: Oligoarticular JIA is often associated with uveitis (requires routine slit-lamp exam); Polyarticular JIA can present as an ankylosing spondylitis picture in older boys and may involve systemic features like Still's disease (picket fence fevers, evanescent rash).
• Asthma Management: The algorithm progresses from rescue inhalers (Albuterol) to daily maintenance medications: Inhaled Corticosteroids -> Long-Acting Beta Agonists (LABA) -> Leukotriene Receptor Antagonists (e.g., Montelukast). Oral steroids are reserved for severe, continuous symptoms.

Learning objectives

• Differentiate the clinical presentations and diagnostic criteria for Kawasaki disease versus other febrile syndromes.
• Classify pediatric arthritis (JIA) based on joint involvement (oligoarticular vs polyarticular) and associated systemic features.
• Apply age-appropriate knowledge to distinguish between developmental hip pathologies: LCP, SCFE, and Osgood-Schlatter disease.
• Accurately differentiate the signs and symptoms of upper airway obstruction (Croup/Epiglottitis) from lower airway obstruction (Bronchiolitis).
• Outline the stepwise pharmacological management algorithm for chronic asthma exacerbations.

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