Kawasaki Disease

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Question 1 of 7

1. Question
Which of these statements is true?
- Kawasaki disease is rarer than bacterial meningitis.
- Kawasaki disease is more common than measles.
- Kawasaki disease accounts for 100 hospital admissions each year in the UK.
- Kawasaki disease follows Mendelian inheritance.
- Kawasaki disease only effects children under 5 years of age.
Question 2 of 7

2. Question
Regarding the pathophysiology of Kawasaki disease, which of these statements is false?
- Vaccines have not been proven to trigger Kawasaki disease.
- There is likely to be both a genetic and infectious component.
- Coronary aneurysms, stenosis and thrombosis are all known complications of Kawasaki disease.
- Involvement of the small and medium sized vessels is classical of Kawasaki disease.
- Lymphocytic infiltration occurs in the first 2 weeks causes destruction of the tunica adventitia.
Question 3 of 7

3. Question
Regarding the principal clinical features of Kawasaki disease, which statement is correct?
- Skin peeling is a characteristic sign and is one of the earliest features to present.
- Lymphadenopathy is usually bilateral and tender.
- Exudative conjunctivitis is common in the early phases of disease.
- Cracked, dry, peeling lips with “strawberry” tongue is always present.
- Evidence of petechial rashes should prompt a search for an alternative diagnosis.
Question 4 of 7

4. Question
The diagnosis of Kawasaki disease is challenging. Which of these statements is correct?
- The strongest defining symptom is a persistent fever >38°C for 5 days.
- The American Heart Association diagnostic criteria identifies all children with Kawasaki disease.
- Once clinical features of Kawasaki disease are present, they will not disappear until treatment is initiated.
- Echocardiography can rule out Kawasaki disease.
- Kawasaki disease can be ruled out if there are no principal features on examination.
Question 5 of 7

5. Question
Annie is an 18-month-old girl who has presented with a nine day history of fever. She has previously been treated with a three day course of trimethoprim from her GP for a presumed UTI.

As part of her diagnostic work up bloods and urinalysis are performed.

Which statement is incorrect?
- A high platelet count is common in Kawasaki disease and peaks after 2-3 weeks.
- Inflammatory markers are nearly always elevated in Kawasaki disease.
- Urinalysis revealing white cells means a UTI is more likely and Kawasaki disease can be excluded.
- Anaemia is common in patients with Kawasaki disease.
- Approximately 40% of children have abnormal LFTs in Kawasaki disease.
Question 6 of 7

6. Question
Alan, a 4-year-old boy, has presented with a 12 day history of fever, rash and irritability. His ED assessment is as follows:
- A own
- B RR 24, Sat 98% RA, chest clear, normal work of breathing
- C CRT 2s, HR 145 regular, HS normal, dry cracked lips with erythema of oral mucosa
- D irritable, 38.5°C, no apparent neck stiffness
- E diffuse maculopapular erythematous rash involving the trunk and extending into the groin, erythematous conjunctiva bilaterally with no obvious exudate, ENT examination NAD, left sided anterior cervical lymphadenopathy is present.
Which statement regarding Alan’s management is correct?
- Aspirin should not be given due to the risk of Reye’s syndrome.
- A transthoracic echo should be performed prior to the administration of IVIG.
- The treatment window for IVIG is 10 days, after this the risks outweigh the benefits.
- IVIG and aspirin should be commenced as soon as possible.
- FBC, U&Es, LFTs, CRP and ESR should be sent to confirm diagnosis.
Question 7 of 7

7. Question
The main goal of treatment with IVIG and aspirin is to…
- Reduce the duration of fever.
- Prevent secondary bacterial co-infection.
- Reduce the rate of cardiac complications and thrombosis.
- Reverse oral mucosal damage.
- Prevent permanent vision loss.

Kawasaki Disease – Post Test

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