The differential diagnosis of leukocoria includes all of the following EXCEPT

Correct Answer: D

Rationale: The correct answer is D) retinal artery occlusion. Leukocoria, the abnormal white reflection in the eye, is a concerning sign in pediatric patients that can be indicative of serious conditions like retinoblastoma, larval granulomatosis, and endophthalmitis. Retinal artery occlusion, while a significant ophthalmic emergency, does not typically present with leukocoria. Retinoblastoma is a primary concern in cases of leukocoria due to its association with this symptom in pediatric patients. Larval granulomatosis, caused by toxocara infection, can also present as leukocoria. Endophthalmitis, an inflammatory condition of the eye, can lead to leukocoria as well. Educationally, understanding the differential diagnosis of leukocoria is crucial for healthcare providers, especially those working with pediatric populations. Recognizing these conditions promptly is essential for timely intervention and management, potentially impacting the child's visual outcome and overall prognosis.

Correct Answer: D

Rationale: The correct answer is D) The visual acuity of newborns is approximately 20/100 but is usually 20/20 by 3-6 months of age. This statement is not true because newborns actually have poor visual acuity, around 20/400, which gradually improves over the first few months of life. By 3-6 months, most infants achieve a visual acuity of around 20/20. Option A is true because the cornea of premature infants can appear opalescent due to incomplete development. Option B is also true as superficial retinal hemorrhages can occur in normal infants during and after birth due to the birthing process. Option C is also accurate as newborns typically have a light blue or gray iris that undergoes a color change over the first few months of life. Educationally, understanding the normal development of the eye in infants is crucial for healthcare professionals, especially those working with pediatric populations. Recognizing these normal developmental milestones can help in early detection of any abnormalities or disorders that may require intervention. This knowledge is also essential for educating parents about what to expect in their child's visual development and when to seek professional evaluation if necessary.

Correct Answer: D

Rationale: Rationale: The correct answer is D) Inheritance as an autosomal dominant trait. Aniridia is a genetic disorder characterized by the absence of the iris in the eye. It is most commonly caused by a mutation in the PAX6 gene, which is inherited as an autosomal dominant trait. This means that an affected individual has a 50% chance of passing on the gene to each offspring. Option A) Trauma is incorrect because aniridia is not typically caused by physical injury to the eye. Option B) Congenital infection is incorrect as aniridia is not associated with infections during pregnancy. Option C) Wilms tumor is incorrect as it is a type of kidney cancer found in children and is not related to aniridia. In an educational context, understanding the genetic basis of aniridia is crucial for healthcare providers caring for pediatric patients with this condition. Recognizing that aniridia is inherited as an autosomal dominant trait can help in providing genetic counseling to families and in managing the ocular and systemic complications associated with this disorder. It also emphasizes the importance of a thorough family history assessment in diagnosing and managing pediatric HEENT disorders.

Correct Answer: D

Rationale: In this question about ophthalmia neonatorum caused by Chlamydia trachomatis, the correct answer is D) Recommended treatment is cefotaxime or ceftriaxone. The correct answer is right because the recommended treatment for ophthalmia neonatorum caused by Chlamydia trachomatis is topical erythromycin ointment, not cefotaxime or ceftriaxone. These antibiotics are not effective against Chlamydia trachomatis. Option A is incorrect because conjunctivitis usually develops within 5-14 days of age in infants with ophthalmia neonatorum caused by Chlamydia trachomatis. Option B is incorrect because Chlamydial conjunctivitis can lead to serious complications if left untreated, such as corneal scarring and chronic conjunctivitis. Option C is incorrect because ten to 20% of infants exposed to Chlamydia trachomatis can develop pneumonia, not just conjunctivitis. Educationally, understanding the correct treatment for ophthalmia neonatorum is crucial for pediatric nurses and healthcare providers to provide appropriate care and prevent complications in newborns. It is essential to differentiate between the treatment options to ensure optimal management of neonatal eye infections caused by Chlamydia trachomatis.

Correct Answer: B

Rationale: The correct answer is B) Glaucoma. In pediatric patients, glaucoma can present with symptoms such as increased corneal size, cloudy cornea, increased tearing, and sensitivity to light, which are all indicative of elevated intraocular pressure. Glaucoma in children can be primary or secondary to other conditions. Timely recognition and treatment are crucial to prevent permanent vision loss in pediatric patients. Option A) Retinoblastoma is a malignant tumor of the retina that typically presents with leukocoria (white pupil reflex) or strabismus, not corneal enlargement. Option C) Chorioretinitis is inflammation of the choroid and retina, which may present with symptoms like floaters, decreased vision, and pain, but not corneal enlargement. Option D) Aniridia is a congenital condition characterized by partial or complete absence of the iris, leading to photophobia and decreased visual acuity, but not corneal enlargement. Educationally, understanding the signs and symptoms of pediatric HEENT disorders, including glaucoma, is essential for nurses and healthcare providers caring for pediatric patients. Recognizing these conditions promptly through comprehensive assessments can lead to early intervention and improved outcomes for children with vision-related issues.