A 10-year-old sustained a spider bite on his ankle a week ago and now presents with redness, swelling, and tenderness. He denies any other fall or injury. X-ray of the ankle is unremarkable. CBC shows elevated WBC. What is the most likely diagnosis for this child?
Compartment syndrome
Osteomyelitis
Osteogenesis imperfecta
Juvenile idiopathic arthritis
The Correct Answer is B
Choice A reason:
Compartment syndrome is a condition where increased pressure within a muscle compartment leads to decreased blood flow, which can cause muscle and nerve damage. It is typically associated with severe trauma, fractures, or crush injuries. The symptoms include severe pain, swelling, and decreased sensation or movement in the affected limb. In this case, the child’s symptoms of redness, swelling, and tenderness following a spider bite, along with an elevated WBC, are more indicative of an infection rather than compartment syndrome.
Choice B Reason:
Osteomyelitis is an infection of the bone, which can occur following an injury or infection elsewhere in the body. The symptoms include redness, swelling, tenderness, and pain in the affected area, along with fever and elevated WBC. Given the child’s history of a spider bite and the presence of redness, swelling, tenderness, and elevated WBC, osteomyelitis is the most likely diagnosis. The unremarkable X-ray does not rule out osteomyelitis, as early stages of the infection may not show changes on X-ray.
Choice C Reason:
Osteogenesis imperfecta, also known as brittle bone disease, is a genetic disorder characterized by fragile bones that break easily. It is not associated with infections or elevated WBC. The symptoms of osteogenesis imperfecta include frequent fractures, blue sclerae, and hearing loss. The child’s symptoms of redness, swelling, and tenderness following a spider bite, along with an elevated WBC, are not consistent with osteogenesis imperfecta.
Choice D Reason:
Juvenile idiopathic arthritis (JIA) is a type of arthritis that occurs in children. It is characterized by persistent joint inflammation, pain, and swelling. While JIA can cause joint tenderness and swelling, it is not typically associated with a recent injury or infection, such as a spider bite. Additionally, JIA does not usually cause elevated WBC. The child’s symptoms are more indicative of an infection, making osteomyelitis the more likely diagnosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
A low-fat, low-carbohydrate diet is not specifically recommended for children with acute glomerulonephritis. The primary dietary concern for these children is managing fluid retention and blood pressure, which is more directly influenced by salt intake rather than fat or carbohydrate intake.
Choice B Reason:
Decreasing the number of calories in the child’s diet is not a primary recommendation for managing acute glomerulonephritis. While maintaining a healthy weight is important, the focus should be on reducing salt intake to manage edema and blood pressure.
Choice C Reason:
Avoiding salt is crucial for children with acute glomerulonephritis. Salt can lead to water retention, which exacerbates edema and can increase blood pressure. Therefore, it is important to limit salt intake to help manage these symptoms.
Choice D Reason:
Increasing the amount of protein in the diet is not recommended for children with acute glomerulonephritis. In fact, protein intake may need to be limited because the kidneys are less able to filter waste products from protein metabolism. Excessive protein can put additional strain on the kidneys.
Correct Answer is C
Explanation
The correct answer is c. An excessive destruction of platelets.
Choice A: Diffuse fibrin deposition in the microvasculature
Diffuse fibrin deposition in the microvasculature is not characteristic of immune thrombocytopenia (ITP). This description is more aligned with disseminated intravascular coagulation (DIC), a condition where widespread clotting occurs within the blood vessels, leading to multiple organ damage.
Choice B: Deficiency in the production rate of globin chains
A deficiency in the production rate of globin chains is associated with thalassemia, a genetic blood disorder that affects the production of hemoglobin. This is not related to the pathology of immune thrombocytopenia.
Choice C: An excessive destruction of platelets
An excessive destruction of platelets is the hallmark of immune thrombocytopenia (ITP). In ITP, the immune system mistakenly targets and destroys platelets, which are essential for blood clotting. This leads to a low platelet count and an increased risk of bleeding.
Choice D: Bone marrow failure in which all elements are suppressed
Bone marrow failure in which all elements are suppressed is characteristic of aplastic anemia, a condition where the bone marrow fails to produce sufficient blood cells. This is not related to immune thrombocytopenia.
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