Type 1 diabetes mellitus is suspected in a child. Which clinical manifestation may be present?

Choice A reason:

Reducing blood pressure is not a primary management goal for nephrotic syndrome in children. While hypertension can be a complication of nephrotic syndrome, the main focus of treatment is on managing proteinuria, edema, and preventing complications. Blood pressure management may be necessary, but it is not the primary goal.

Choice B reason:

Increasing the excretion of urinary protein is not a desired goal in the management of nephrotic syndrome. In fact, one of the main objectives is to reduce proteinuria (excessive protein in the urine) because it leads to hypoalbuminemia (low levels of albumin in the blood) and edema. Therefore, increasing urinary protein excretion would worsen the condition.

Choice C reason:

Increasing the ability of tissues to retain fluid is not a management goal for nephrotic syndrome. The condition is characterized by edema due to fluid retention, and the goal is to reduce this edema by managing proteinuria and using diuretics if necessary. Therefore, increasing fluid retention would be counterproductive.

Choice D reason:

Reducing the excretion of urinary protein is a primary management goal for nephrotic syndrome1. Proteinuria is a hallmark of the condition, and reducing it helps to alleviate hypoalbuminemia and edema. Treatment often includes corticosteroids to reduce inflammation and protein leakage, as well as other medications to manage symptoms and prevent complications.

The correct answer is c. Nonsteroidal anti-inflammatory drugs (NSAIDs)

Choice A reason:

Aspirin was once commonly used to treat juvenile idiopathic arthritis (JIA), but it is no longer the first-line treatment due to its potential side effects, such as gastrointestinal issues and Reye’s syndrome in children. While it can still be used in some cases, it is not the preferred initial treatment.

Choice B Reason:

Corticosteroids are effective in reducing inflammation and controlling symptoms of JIA, but they are not typically used as the first-line treatment due to their potential side effects, including weight gain, growth suppression, and increased risk of infections. They are usually reserved for more severe cases or when other treatments have failed.

Choice C Reason:

Nonsteroidal anti-inflammatory drugs (NSAIDs) are usually the first-line treatment for juvenile idiopathic arthritis. They help reduce inflammation, relieve pain, and improve joint function. NSAIDs are generally well-tolerated and have a long track record of safety and effectiveness in managing JIA.

Choice D Reason:

Disease Modifying Anti-Rheumatoid Drugs (DMARDs), such as methotrexate, are used in the treatment of JIA, but they are not typically the first-line treatment. DMARDs are often prescribed when NSAIDs are not sufficient to control the symptoms or when the disease is more severe. They help slow the progression of the disease and prevent joint damage.