An 18-months old infant weighing 10 kg develops an acute anaphylactic reaction with bronchospasm towards antibiotic injection. What is the most appropriate initial treatment?

Correct Answer: C

Rationale: In the scenario presented, the most appropriate initial treatment for the 18-month-old infant experiencing acute anaphylaxis with bronchospasm towards antibiotic injection is option C) Inj. Epinephrine 0.01 mg IV/IM stat. This is the correct choice because epinephrine is the first-line treatment for anaphylaxis, especially when there is respiratory compromise such as bronchospasm. In this pediatric case, the dose of epinephrine is weight-based (0.01 mg/kg), making it the most suitable option for this 10 kg infant. Option A) Inj. Hydrocortisone 100 mg IV stat is not the most appropriate initial treatment in this acute situation. While corticosteroids like hydrocortisone play a role in the management of anaphylaxis, they are not the first-line treatment for acute bronchospasm and should be administered after epinephrine. Option B) Inj. Epinephrine 0.1 mg IV/IM stat is a higher dose than recommended for this infant's weight and age. Using this higher dose could lead to adverse effects, especially in pediatric patients. Option D) Nebulization Salbutamol + oxygen is not the most appropriate initial treatment for acute anaphylaxis with bronchospasm. While bronchodilators like salbutamol can help with bronchospasm, epinephrine remains the first-line treatment due to its broader effects in anaphylactic reactions. Educationally, it is crucial for healthcare providers to understand the principles of managing anaphylaxis, especially in pediatric patients. Knowing the correct dosages and medications for different age groups is essential to provide safe and effective care in such critical situations. Weight-based dosing is particularly crucial in pediatrics to avoid medication errors and ensure optimal outcomes for the patient.

Correct Answer: D

Rationale: In the context of newborns, understanding common dermatological conditions is essential for healthcare providers. In this question, the correct answer is D) Infantile acropustulosis. Infantile acropustulosis is not a normal variant in newborns; it is a skin condition characterized by itchy, small, red bumps on the hands and feet. This condition is not considered a typical occurrence in healthy newborns. A) Milia is a common and benign condition in newborns, presenting as small white bumps on the face due to blocked oil glands. B) Neonatal pustular melanosis is a transient condition characterized by pustules on a pigmented background, commonly seen in newborns of color. C) Dermal melanocytosis, such as Mongolian spots, are common in newborns with darker skin tones and are considered normal variants. Educationally, understanding these differences is crucial for healthcare providers working with newborns. Recognizing normal variants versus abnormal conditions helps in providing appropriate care and reassurance to parents. It also aids in early identification and management of any potential health issues that may arise in newborns. It highlights the importance of thorough assessment and knowledge of pediatric dermatology in clinical practice.

Correct Answer: A

Rationale: The presence of "blueberry muffin" lesions in infants with rubella is due to dermal erythropoiesis. This occurs when the bone marrow, in response to an infection like rubella, releases immature erythroid cells into the bloodstream, which then accumulate in the skin, causing the characteristic purplish skin lesions. Option B, thrombocytopenia, is incorrect because it refers to a low platelet count, which would not directly cause the blueberry muffin lesions seen in rubella. Option C, ecchymosis, is incorrect as ecchymosis presents as bruising due to blood leaking from damaged vessels, not the same mechanism as seen in blueberry muffin lesions. Option D, vasculitis, is also incorrect as it refers to inflammation of blood vessels, which is not the primary cause of these lesions in rubella. In an educational context, understanding the pathophysiology behind skin manifestations in pediatric conditions like rubella is crucial for nurses to provide effective care. Recognizing these distinctive skin findings can aid in early diagnosis and appropriate management of the underlying condition. Pharmacological interventions may also be necessary in some cases, highlighting the importance of pharmacology knowledge in pediatric nursing practice.

Correct Answer: D

Rationale: In the treatment of transient tyrosinemia of newborn, the correct vitamin to be used is Vitamin C (ascorbic acid). This is because Vitamin C plays a crucial role in the metabolism of tyrosine, the amino acid involved in tyrosinemia. Vitamin C helps in the conversion of tyrosine to other important compounds, aiding in the management of transient tyrosinemia. On the other hand, the other options - Vitamin A, Vitamin K, and Vitamin E - are not directly involved in the metabolism of tyrosine or the treatment of transient tyrosinemia. Vitamin A is essential for vision and immune function, Vitamin K is important for blood clotting, and Vitamin E is an antioxidant that protects cells from damage. Understanding the specific roles of different vitamins in metabolic pathways and disease processes is crucial for healthcare professionals, especially in pharmacology and pediatrics. It helps in making informed decisions about treatment options and ensures optimal patient care. In the case of transient tyrosinemia of newborn, knowing that Vitamin C is the appropriate choice can make a significant difference in the outcome for the infant.

Correct Answer: A

Rationale: In the diagnosis of Hirschsprung's disease, histochemical staining using acetylcholine esterase is crucial. The enteric nervous system in the colon of individuals with Hirschsprung's disease lacks ganglion cells, which are responsible for releasing acetylcholine. Therefore, staining for acetylcholine esterase helps identify the absence of these cells in affected areas, confirming the diagnosis. Option B, Dopamine, is not used for diagnosing Hirschsprung's disease. Dopamine is a neurotransmitter primarily associated with the central nervous system and is not relevant to the enteric nervous system abnormalities seen in this condition. Option C, Glutamate, is also not used for diagnosing Hirschsprung's disease. Glutamate is an excitatory neurotransmitter that plays a role in various processes in the brain but is not specifically linked to the pathology of this pediatric gastrointestinal disorder. Option D, Chromogranin and synaptophysin, are markers used in neuroendocrine tumors and are not typically employed in the diagnosis of Hirschsprung's disease, which primarily involves abnormalities in the enteric nervous system in the colon. Understanding the specific staining techniques and markers used in the diagnosis of various conditions is essential for healthcare professionals, especially in specialties like pediatric nursing where early and accurate diagnosis is critical for providing appropriate care and interventions.