Which of the following disease is characterized by enlargement and tenderness of the parotid gland?

RUHS, Jaipur, PB B.Sc Nursing Entrance-2019

Medical Surgical Nursing

Easy

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2019

Explanation

Mumps is a viral illness caused by a paramyxovirus, which specifically targets glandular tissues.
The most characteristic feature of mumps is parotitis, the acute, painful inflammation and swelling of one or both parotid salivary glands.
This swelling is typically visible in front of the ears and can obscure the angle of the jaw, pushing the earlobe upward and outward.
Pain is often exacerbated by chewing or by consuming sour or acidic substances that stimulate salivation.

Option A: Measles (rubeola) is not primarily characterized by parotid swelling. Its hallmark signs are Koplik's spots on the buccal mucosa, followed by a maculopapular rash, along with high fever, cough, coryza, and conjunctivitis (the '3 Cs').
Option C: Rubella (German measles) is characterized by a fine, pink rash and prominent swelling of the lymph nodes behind the ears (postauricular) and at the back of the neck (suboccipital), not the parotid glands.
Option D: Chickenpox (varicella) is defined by its intensely itchy vesicular rash that appears in successive waves or 'crops'. Parotid swelling is not a feature of chickenpox.

Clinical Relevance

Nursing practice connection: Knowing Identification of communicable diseases based on clinical signs helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must implement droplet and contact precautions for a patient with mumps for at least 5 days after the onset of parotitis to prevent transmission in a healthcare setting.
Patient education is key and should focus on comfort measures like a soft diet, avoiding acidic foods that stimulate saliva and cause pain, and using warm or cold compresses on the swollen glands.
A crucial nursing responsibility is to monitor for and report signs of serious complications, especially in adults. These include severe headache/stiff neck (meningitis) and testicular pain/swelling (orchitis).

How to Approach the Question

First, identify the key clinical sign described in the question stem: 'enlargement and tenderness of the parotid gland'.
Recognize this specific sign, parotitis, as the hallmark or pathognomonic symptom of a particular disease.
Systematically review the four options provided: Measles, Mumps, Rubella, and Chickenpox.
Recall the primary characteristics of each of these common childhood viral illnesses.
Match the hallmark sign (parotitis) to the correct disease (Mumps), while mentally ruling out the other options based on their distinct primary symptoms (e.g., Koplik's spots for measles, vesicular rash for chickenpox).

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1975-1977

E6 Medicine Harrison 22e Part 1 p. 1688-1690