Which of the following is a characteristic finding of Kawasaki disease?

Appeared in: DSSSB 13 August 2024

Explanation

Strawberry tongue is a hallmark sign of Kawasaki disease, an acute vasculitis affecting children.
This finding falls under the 'S' in the widely used CRASH mnemonic for diagnosing Kawasaki disease, representing changes to the oral mucosa.
It is characterized by a swollen, bright red tongue with enlarged papillae, resembling a strawberry.
This sign, along with other criteria like high fever and rash, is crucial for early diagnosis and treatment to prevent cardiac complications.

Option B: A beefy red tongue is not associated with Kawasaki disease. It is a classic sign of a nutritional deficiency.
Option C: Caput medusae is a sign of advanced liver disease and has no connection to Kawasaki disease, which is a pediatric vasculitis.
Option D: Fetor hepaticus is a specific breath odor indicating severe liver failure, not a finding in Kawasaki disease.

Clinical Relevance

Nursing practice connection: Knowing Clinical manifestations of Kawasaki disease helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Early recognition of signs like strawberry tongue is critical for diagnosing Kawasaki disease promptly.
Prompt treatment with intravenous immunoglobulin (IVIG) and aspirin is essential to reduce the risk of coronary artery aneurysms, the most serious complication of Kawasaki disease.
What if? If a child presents with a high fever and a rash but no strawberry tongue, the clinician must still consider Kawasaki disease (incomplete KD) if other features are present, as not all patients exhibit all five classic signs.

How to Approach the Question

First, identify the core concept of the question, which is identifying a key sign of Kawasaki disease.
Recall the diagnostic criteria for Kawasaki disease. A useful mnemonic is 'CRASH and Burn' (Conjunctivitis, Rash, Adenopathy, Strawberry tongue, Hand/foot changes, and Burn/Fever).
Evaluate each option against these criteria. 'Strawberry tongue' directly matches the 'S' in the mnemonic.
Analyze the other options to confirm they are incorrect. Recognize that 'beefy red tongue' relates to anemia, while 'caput medusae' and 'fetor hepaticus' are signs of severe liver disease.
This process of matching the sign to the disease and eliminating distractors related to other body systems confirms the correct answer.

Concept Tested & Keywords

Q_0a80OtxTOoVHOQuAeu3S

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1543-1545

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 658-660

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 735-737

Practise the full DSSSB 13 August 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.