Burns are commonly seen in child abuse. Approximately 10% of children hospitalized with burns are victims of abuse. Of the following, inflicted burn can be MOST commonly the result of

Correct Answer: D

Rationale: In the context of pediatric burns and child abuse, the correct answer is D) scalding injuries because they are the most commonly inflicted burn in cases of child abuse. Scald burns result from contact with hot liquids or steam, and they can be deliberately inflicted by an abuser. Children are especially vulnerable to scald burns due to their sensitive skin and inability to move away from the source of injury quickly. Option A) contact with a hot iron is less common in cases of child abuse as it requires direct contact with a hot object, which may leave distinct patterns of injury different from typical abuse-related burns. Option B) contact with radiators is also less common in child abuse cases and may result in different patterns of burns compared to scald injuries typically seen in abuse cases. Option C) cigarette application can cause burns, but it is less commonly associated with child abuse compared to scalding injuries. In cases of child abuse, inflicted burns are more likely to be severe and widespread, often involving patterns suggestive of intentional harm. Educationally, understanding the patterns and common mechanisms of different types of burns in pediatric patients is crucial for healthcare providers, especially those working in pediatric emergency or critical care settings. Recognizing the signs of abuse-related burns and knowing the appropriate interventions and reporting protocols are vital to safeguarding the well-being of vulnerable children.

Correct Answer: B

Rationale: In pediatric oncology, tumor lysis syndrome (TLS) is a potentially life-threatening complication that can occur after initiating chemotherapy. Metabolic derangements in TLS result from the rapid release of intracellular contents into the bloodstream. The correct answer, B) hypernatremia, is not typically associated with TLS in children. A) Hyperuricemia is a common finding in TLS due to the release of uric acid from lysed cells. C) Hyperkalemia occurs as potassium is released from damaged cells, leading to potential cardiac arrhythmias. D) Hyperphosphatemia is also a hallmark of TLS, as phosphorus is released from lysed cells, potentially causing renal damage. Educationally, understanding the metabolic effects of TLS is crucial for nurses caring for pediatric oncology patients. Recognizing these electrolyte imbalances promptly can guide appropriate interventions to prevent complications such as renal failure or cardiac arrhythmias. Nurses play a vital role in monitoring, assessing, and managing TLS in collaboration with the healthcare team to ensure the best outcomes for pediatric patients undergoing cancer treatment.

Correct Answer: C

Rationale: In this question, the correct answer is C) anaplastic histology. Explanation: Wilms tumor relapse is more common in cases with unfavorable histology, such as anaplastic histology. Anaplastic Wilms tumor is associated with a higher risk of relapse and poorer outcomes compared to other histological subtypes. Therefore, this option is incorrect in the context of relapse in Wilms tumor. A) Low stage (I/II) at diagnosis is incorrect because relapse can occur regardless of the initial stage of the tumor. B) No prior radiotherapy is incorrect because relapse can still occur even if radiotherapy was not part of the initial treatment plan. D) More than 12 months from nephrectomy is incorrect because relapse can occur at any time post-surgery, not exclusively within a specific timeframe. Educational Context: Understanding the risk factors and outcomes associated with Wilms tumor relapse is crucial for healthcare providers caring for pediatric oncology patients. Recognizing the factors that may contribute to relapse can aid in monitoring and managing these patients effectively. Anaplastic histology is a significant risk factor for relapse in Wilms tumor, emphasizing the importance of histological classification in treatment planning and prognostication.

Correct Answer: B

Rationale: In the context of pediatric melanoma risk factors, the correct answer is option B) dark-skinned child. Melanoma is more commonly associated with fair-skinned individuals due to their reduced ability to produce protective melanin in response to UV radiation exposure. Dark-skinned individuals have more melanin, which provides some level of protection against melanoma development. Option A) positive family history of melanoma is a well-known risk factor as genetic predisposition can play a role in the development of melanoma. Option C) hairy nevus and option D) dysplastic nevus are also risk factors as these types of moles can potentially transform into melanoma. Educationally, understanding pediatric melanoma risk factors is crucial for healthcare providers working with children. By recognizing these risk factors, healthcare professionals can educate families on preventive measures, conduct regular screenings, and facilitate early detection and treatment if necessary. Emphasizing the significance of risk factors like family history and specific types of moles can help in identifying children at higher risk for melanoma and taking appropriate actions to mitigate that risk.

Correct Answer: C

Rationale: The correct answer is C) children with Down syndrome have a slightly inferior outcome ratio of ALL/AML in general. This statement is incorrect because children with Down syndrome actually have a better prognosis when they develop leukemia, with a higher survival rate compared to children without Down syndrome. Option A is incorrect because acute leukemia does occur more frequently in children with Down syndrome due to genetic factors. Option B is incorrect because children with Down syndrome are actually more likely to develop ALL (Acute Lymphoblastic Leukemia) rather than AML (Acute Myeloid Leukemia). In an educational context, it is important for medical students to understand the specificities of leukemia in children with Down syndrome as it impacts their management and prognosis. Providing accurate information about the incidence, types, and outcomes of leukemia in this population is crucial for delivering quality care to these patients.