A 7-year-old child has been admitted to the hospital with a diagnosis of acute rheumatic fever. When taking a health history from the child’s mother, which recent illness is of most significance?

Choice A rationale
Chickenpox is a viral infection that can cause a fever and rash. However, it is not typically associated with the development of acute rheumatic fever. Acute rheumatic fever is an inflammatory disease that can develop when strep throat or scarlet fever isn’t properly treated.
Choice B rationale
Mumps is a viral infection that causes swelling of the salivary glands. Like chickenpox, it is not typically associated with the development of acute rheumatic fever.
Choice C rationale
A recent history of sore throat is significant because acute rheumatic fever can develop as a complication of an untreated strep throat infection. Strep throat is caused by group A Streptococcus bacteria, which can trigger an immune response leading to rheumatic fever if not treated properly.
Choice D rationale
Influenza, or the flu, is a viral infection that can cause a range of symptoms, including fever, cough, and body aches. However, it is not typically associated with the development of acute rheumatic fever.

Choice A rationale
Juvenile idiopathic arthritis (JIA) is a chronic condition that can cause joint damage and pain. Physical therapy is an essential part of managing JIA, and it often includes a variety of exercises to improve strength, flexibility, and overall joint health. One of the recommended physical activities for JIA patients is exercising in a swimming pool. Water-based exercises, also known as hydrotherapy, are beneficial because the buoyancy, resistance, and warmth of water can help reduce joint stress, increase muscle strength, and improve range of motion.
Choice B rationale
While regular exercise is important for adolescents with JIA, starting a training program that involves weight lifting and running might not be the best option. These activities can put excessive strain on the joints and potentially exacerbate symptoms. It’s crucial to choose low-impact exercises that won’t put too much stress on the joints.
Choice C rationale
Passive range of motion exercises can be beneficial for maintaining joint mobility in JIA patients. However, these exercises alone may not be sufficient for strengthening and mobilizing the joints and surrounding muscles. A comprehensive physical therapy regimen, including a combination of strengthening, stretching, and aerobic exercises, is typically recommended.
Choice D rationale
Splinting can be used in JIA management to help maintain bone and joint alignment and prevent deformities. However, splinting is typically used as an adjunct to other treatments and not as the primary method of encouraging joint mobilization and muscle strengthening. Therefore, while splinting can be beneficial, it should not be the only strategy implemented for physical therapy.