Chronic uveitis is one of the extraarticular manifestations of various subtypes of juvenile idiopathic arthritis. All the following are risk factors for the development of uveitis EXCEPT

Correct Answer: D

Rationale: Rationale: The correct answer is option D) severity of arthritis. Chronic uveitis is a common extraarticular manifestation in juvenile idiopathic arthritis (JIA) patients, particularly in the oligoarthritis subtype, females, and those who are ANA-positive. However, the severity of arthritis itself is not a direct risk factor for the development of uveitis. In oligoarthritis, which affects fewer joints, the risk of uveitis is higher compared to polyarthritis. Females have a higher predisposition to uveitis compared to males, and ANA positivity is associated with an increased risk of developing uveitis in JIA. Educational Context: Understanding the risk factors associated with chronic uveitis in JIA is crucial for pediatric nurses caring for children with this condition. By knowing these risk factors, nurses can monitor and educate patients and families about the importance of regular eye screenings to detect uveitis early and prevent potential complications. Recognizing the relationship between specific subtypes of JIA, gender, and laboratory findings like ANA can guide healthcare providers in delivering comprehensive care to pediatric patients with JIA.

Correct Answer: C

Rationale: The correct answer is C) cardiac arrhythmias. In Juvenile dermatomyositis (JDM), cardiac involvement is rare compared to other complications like respiratory muscle weakness leading to aspiration, gastrointestinal bleeding due to medications like corticosteroids, and muscle atrophy from prolonged inflammation and disuse. In the context of JDM, the least common complication is cardiac arrhythmias because although cardiac involvement can occur in JDM, it is not as prevalent or severe as the other complications listed. Understanding the hierarchy of complications in JDM is crucial for pediatric nurses to prioritize care and monitoring for these patients. Therefore, nurses caring for patients with JDM should be vigilant for symptoms of respiratory muscle weakness, gastrointestinal bleeding, and muscle atrophy, as these are more commonly seen in this condition compared to cardiac arrhythmias. This knowledge will help nurses provide comprehensive and targeted care to manage potential complications effectively.

Correct Answer: C

Rationale: The correct answer is C) familial Mediterranean fever. Colchicine is known to be effective in preventing the development of AA amyloidosis in patients with familial Mediterranean fever. This is because familial Mediterranean fever is an autoinflammatory disorder characterized by recurrent attacks of fever and inflammation, which can lead to the deposition of amyloid proteins in various tissues. Option A) juvenile idiopathic arthritis is incorrect because colchicine is not typically used in the treatment or prevention of AA amyloidosis associated with this condition. Juvenile idiopathic arthritis is managed using other medications like nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs). Option B) ankylosing spondylitis is also incorrect as colchicine is not a standard treatment for this condition. Ankylosing spondylitis is usually managed with NSAIDs, physical therapy, and in some cases, biologic medications targeting specific inflammatory pathways. Option D) hyper IgD syndrome is not associated with the development of AA amyloidosis, and colchicine is not commonly used in its management. Hyper IgD syndrome is a rare autoinflammatory disorder characterized by recurrent fevers, lymphadenopathy, and elevated IgD levels, and its treatment typically involves anti-inflammatory medications and sometimes biologics. In an educational context, understanding the appropriate use of medications in different diseases is crucial for healthcare providers, especially pediatric nurses working with children with complex medical conditions. Knowing the indications and contraindications of drugs like colchicine can help nurses provide safe and effective care to pediatric patients with conditions like familial Mediterranean fever.

Correct Answer: B

Rationale: In the context of caring for foster care children as a pediatrician, the most common significant problem being abuse and neglect (Option B) makes sense as the correct answer. Foster care children often come from backgrounds where they have experienced trauma, abuse, or neglect, leading to a higher prevalence of these issues among this population. As a newly employed pediatrician in this setting, it is crucial to be vigilant for signs of abuse and neglect, as addressing these issues is paramount for the well-being and safety of the children. Option A, chronic medical problems, while common in pediatric populations in general, may not be the most prevalent issue among foster care children specifically. These children may have experienced trauma or neglect that can manifest in behavioral or emotional concerns rather than primarily chronic medical conditions. Option C, mental health concerns, is also a significant issue among foster care children, but abuse and neglect often underlie and contribute to the development of mental health issues in this population. Addressing the root cause of trauma is crucial in managing mental health concerns effectively. Option D, family relationship problems, while important, may not be the most common significant problem among foster care children. Many of these children are in foster care due to family-related issues such as abuse or neglect, making these more pressing concerns to address initially. Educationally, understanding the prevalence of abuse and neglect among foster care children is essential for healthcare providers working with this population. Recognizing and addressing these issues early can lead to better outcomes for the children and help create a safer and supportive environment for them to thrive. It underscores the importance of trauma-informed care and the need for comprehensive assessments in caring for foster care children.

Correct Answer: D

Rationale: The correct answer is D) glutaric aciduria type 1. This condition is a rare metabolic disorder that can lead to intracranial bleeding, especially in infants with macrocephaly and hypotonia. The history of difficult labor is also consistent with this diagnosis, as birth trauma can trigger symptoms in affected individuals. Additionally, the initial reassurance by the general Pediatrician highlights the importance of considering metabolic disorders in cases where symptoms may not initially seem severe. Option A) residual birth trauma is incorrect because the presentation is not typical of residual birth trauma, as there is no evidence of skull fracture and the symptoms are more indicative of a metabolic disorder. Option B) arteriovenous malformation is unlikely in this case as the CT scan did not show any vascular abnormalities that would suggest this condition. Option C) acute viral encephalitis is also less likely given the absence of characteristic findings on imaging and the presence of a metabolic disorder that better explains the symptoms. Educationally, this question highlights the importance of considering rare metabolic disorders in infants presenting with neurological symptoms, especially when there is a history of difficult labor and developmental abnormalities. It underscores the need for a comprehensive evaluation and a high index of suspicion for less common conditions in pediatric patients.