Rheumatology: systemic JIA: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Rheumatology: systemic JIA

Sample item

A 5-year-old has daily spiking fever with evanescent salmon-pink rash, arthritis, hepatosplenomegaly and very high ferritin. What complication is feared?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Macrophage activation syndrome

Systemic JIA (Still disease) can trigger macrophage activation syndrome, a form of secondary haemophagocytic lymphohistiocytosis with cytopenias, very high ferritin, coagulopathy and low ESR. Treatment is high-dose steroids, with cyclosporine or anakinra. Biologics such as anti-IL-1 and anti-IL-6 are used.

Option by option

  • A. Chronic uveitis

    Chronic uveitis is typical of oligoarticular JIA.

  • B. Macrophage activation syndrome (correct)

    Correct. MAS is a life-threatening complication.

  • C. Renal tubular acidosis

    RTA is not a typical complication.

  • D. Aortic dissection

    Aortic dissection is not a feature.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, Macrophage activation syndrome. Systemic JIA (Still disease) can trigger macrophage activation syndrome, a form of secondary haemophagocytic lymphohistiocytosis with cytopenias, very high ferritin, coagulopathy and low ESR.

Why is "Chronic uveitis" not the answer?

Chronic uveitis is typical of oligoarticular JIA.

Why is "Renal tubular acidosis" not the answer?

RTA is not a typical complication.

Why is "Aortic dissection" not the answer?

Aortic dissection is not a feature.

What concept does this question test?

It tests Rheumatology: systemic JIA in Pediatrics. Treatment is high-dose steroids, with cyclosporine or anakinra. Biologics such as anti-IL-1 and anti-IL-6 are used.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Rheumatology: systemic JIA?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.