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 D) severity of arthritis. Chronic uveitis is a common extraarticular manifestation of juvenile idiopathic arthritis (JIA). Risk factors for the development of uveitis in JIA include the oligoarthritis subtype, female gender, and ANA-positivity. Oligoarthritis subtype is associated with a higher risk of developing uveitis compared to other subtypes of JIA. Females are more likely to develop uveitis compared to males in the context of JIA. ANA-positivity is a known risk factor for uveitis in JIA patients. The incorrect options (A, B, and C) are risk factors for developing uveitis in JIA, while option D is not. Understanding these risk factors is crucial for healthcare providers, particularly pediatric nurses, who care for children with JIA. Early detection and management of uveitis are essential to prevent vision-threatening complications in these patients. Nurses play a key role in monitoring for signs and symptoms of uveitis in children with JIA, making this knowledge essential for their practice.

Correct Answer: C

Rationale: The correct answer is C) cardiac arrhythmias. In Juvenile dermatomyositis (JDM), cardiac involvement is rare compared to other complications. While JDM primarily affects the skin and muscles, leading to weakness and muscle atrophy, it can also involve other organs like the gastrointestinal tract, leading to issues such as aspiration and gastrointestinal bleeding. Educational Context: Understanding the common complications of JDM is crucial for pediatric nurses to provide comprehensive care to children with this condition. Recognizing the least common complication, such as cardiac arrhythmias, helps nurses prioritize care and monitor patients effectively. By knowing the typical complications, nurses can anticipate potential issues, intervene promptly, and collaborate with the healthcare team to optimize outcomes for children with JDM.

Correct Answer: C

Rationale: Colchicine is an anti-inflammatory medication that is known to be effective in preventing the development of AA amyloidosis, a condition characterized by the deposition of amyloid protein in organs. In this case, the correct answer is C) familial Mediterranean fever (FMF). FMF is an autosomal recessive disease characterized by recurrent episodes of fever, serositis, and arthritis. One of the complications of FMF is the development of AA amyloidosis due to chronic inflammation. Colchicine is the mainstay treatment for FMF and has been shown to reduce the frequency of acute attacks and the risk of developing AA amyloidosis. Option A) juvenile idiopathic arthritis is incorrect because colchicine is not typically used in the treatment of this condition. Juvenile idiopathic arthritis is usually managed with nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and disease-modifying antirheumatic drugs (DMARDs) depending on the subtype. Option B) ankylosing spondylitis is also incorrect as colchicine is not a standard treatment for this condition. Ankylosing spondylitis is managed with NSAIDs, physical therapy, and in some cases, biologic agents like TNF-alpha inhibitors. Option D) hyper IgD syndrome is incorrect because colchicine is not indicated for this genetic autoinflammatory disorder. Hyper IgD syndrome is managed symptomatically, and colchicine is not a primary treatment for this condition. Educationally, understanding the use of colchicine in preventing AA amyloidosis in FMF highlights the importance of appropriate medication choices based on the underlying pathophysiology of a disease. It also emphasizes the significance of recognizing the role of inflammation in certain diseases and how targeted therapies like colchicine can help prevent serious complications like amyloidosis.

Correct Answer: B

Rationale: In the context of caring for foster care children as a pediatrician, the most common significant problem is abuse and neglect (Option B). This is because children in foster care often come from backgrounds where they have experienced trauma, abuse, or neglect, which can have profound impacts on their physical, emotional, and mental well-being. Abuse and neglect are pervasive issues in the lives of many foster care children, leading to a range of health problems, developmental delays, behavioral issues, and emotional challenges. As a pediatrician, it is crucial to be aware of and vigilant for signs of abuse and neglect in these vulnerable children to ensure their safety and well-being. Regarding the other options: - Chronic medical problems (Option A) may be prevalent in some foster care children, but they are not as universally common or pervasive as the effects of abuse and neglect. - Mental health concerns (Option C) are indeed significant in this population, but often stem from the trauma of abuse and neglect. - Family relationship problems (Option D) can be a consequence of abuse and neglect but are not as consistently the primary issue as the abuse and neglect itself. Educationally, understanding the prevalence and impact of abuse and neglect on foster care children is crucial for healthcare providers working with this population. By recognizing the primary challenges these children face, healthcare professionals can better advocate for their needs, provide appropriate interventions, and work towards improving their overall health and well-being.

Correct Answer: D

Rationale: The correct answer is D) glutaric aciduria type 1. In this scenario, the infant's history of difficult labor, macrocephaly, mild hypotonia, and intracranial bleeding following a viral illness suggests an underlying metabolic disorder like glutaric aciduria type 1. This condition can present with macrocephaly, hypotonia, and acute encephalopathy triggered by a catabolic state like a viral illness. The absence of skull fracture and normal fundoscopy point away from trauma. Option A) residual birth trauma is incorrect because the absence of skull fracture and normal fundoscopy do not support this diagnosis. Option B) arteriovenous malformation is less likely given the clinical presentation and absence of predisposing factors. Option C) acute viral encephalitis is less likely as the symptoms are more indicative of a metabolic disorder than an infectious cause. Educationally, this question highlights the importance of recognizing metabolic disorders in pediatric patients presenting with neurological symptoms. Understanding the clinical features, diagnostic clues, and appropriate management of rare conditions like glutaric aciduria type 1 is crucial for pediatric nurses to provide optimal care for infants in critical situations.