High altitudes may produce hypoxemia by:

a. right -to-left shunts             

b. atelectasis                          

c. decreased oxygen inspiration

d. emphysema                        

e. All of the above are correct  

C. Decreased oxygen inspiration

In ARDS, incrased alceolocapillary membrane permeability mainly is due to:

a. alveolar epithelial damage              

b. decreased surfactant                      

c. vasoconstriction                             

d. ventilation to perfusion mismatching

e. inflammatory mediators released     

E. Inflammatory mediators released

Type II pnemocyte damage causes:

a. increased alveolocapillary permeability                      

b. chemotaxis for neutrophils                                       

c. exudation of fluid from capillaries into the interstitium

d. decreased surfactant production                               

e. All of the above are correct                                      

D. Decreased surfactant production

Pulmonary edema may be caused by:

a. hypoventilation

b. CNS abnormalities 

c. atelectasis

d. rupture of pleura

e. increased pulmonary hydrostatic pressure

E. Increased pulmonary hydrostatic pressure

In Asthma:

a. bronchial muscles contract

b. bronchial muscles relax

c. mucous secretions decrease

d. imbalances within the CNS develop

A. Bronchial Muscles Contract

In Emphysema:

a. there is increased area for gaseous exchange

b. there are prolonged inspirations

c. the bronchioles are primarily involved

d. there is increased diaphragm movement

e. alveoli are less able to recoil and expel air 

E. Alveoli are less able to recoil and expel air

In Pneumococcal pnuemonia, the stage of gray hepatization is characterized by:

a. solidification of tissue

b. fibrin deposition

c. alveoli filling with blood cells and pnuemococci

d. macrophages appearing in alveolar spaces 

B. Fibrin Deposition

Pulmonary Hypertension:

a. shows an enlarged pulmonary artery

b. involves deep vein thrombosis

c. shows right ventricular hypertrophy

d. Both a. and c. are correct

e. a. b. and c. are correct

D. Both a. and c. are correct

shows an enlarged pulmonary artery

and shows right ventricular hypertrophy

Cor Pulmonale:

E. a. b. and c. are correct

occurs in response to long standing pulmonary hypertension, is right heart failure, and is manifested by altered tricuspid and pulmonic valve sounds

A lung cancer characterized by many anaplastic figures and the production of hormones is most likely:

a. squamous cell carcinoma

b. small cell carcinoma

c. large cell carcinoma

d. adenocarcinoma

e. bronchial adenoma

B. Small Cell Carcinoma

The matastasis of lung squamous cell carcinoma is:

a. late

b. very early and widespread

c. early

d. early and widespread

e. never seen

A. Late

Which is true about Tuberculosis?

a. It is caused by an aerobic bacillus

b. It may affect other organs

c. It involves a type III hypersensitivity

d. Antibodies to it may be detected with a skin test

A. and B.

It is caused by an aerobic bacillus and it may affect other organs

Pulmonary Emboli usually do which of the following?

a. Obstruct blood supply to lung parenchyma

b. Have origins from thrombi in the legs

c. Occlude pulmonary vein branches

d. Occlude pulmonary artery branches

A. B. and D.

They obstruct blood supply to lung parenchyma, have origins from thrombi in the legs, and occlude the pulmonary artery branches

Chronic bronchitis:

a. Is caused by a lack of surfactant

b. impairs cilia

c. Exhibits a nonproductive cough

d. causes collapsed alveoli  

B. Impairs cilia

Emphysema is precipitated by:

a. histamine

b. TNF

c. leukotrienes

d. alpha– 1 antitrypsin deficiency

D. Alpha- 1 antitrypsin deficiency

Increased ventilatory rate ,very large tidal volume, and no expiratory pause are characteristics of

________________

Kussmaul respirations

Coughing up blood or bloody secretions is

________________

Hemaptysis

Decreased arterial oxygenation causes

_________________

Cyanosis

Apnea, inward ventilation, then apnea again characterize ________________

Cheyne Stokes respirations

Alveolar collapse is observed in ___________

Plural Space  Atelectasis

Abnormal deflation of bronchi is termed

_____________________

Bronchiectasis

Fibrous tissue or nodules in the lungs is termed

_______________________

Pneumoconiosis

Fractured ribs or sternum cause

___________________

Flail chest

Pleural space air is termed

________________

Pneumothorax

Streptococcus pneumoniae causes

__________ ___________

Lobar pneumonia

During times of respiratory distress , the infants just wall may flex inward and limit functional respiratory capacity because of chest wall __________ and

_________________

Flexibility and compliance

At birth, the infant has small, immature alveoli that cause _____________ to air flow

Increased resistance

Surfactant production begins by __________ weeks of gestation

20–24 weeks of gestation

Failure to produce surfactant at birth results in severe _____________ and RDS of the newborn

Atelectasis

________________ is a disease process primarily caused by hyper-responsive airways that are sensitive to certain environmental triggers.

Asthma

Children have greater________ and__________ than do adults.

Metabolic rates and oxygen consumption

Epiglottitis is characterized by :

B. Severe stridor

Laryngotracheobronchitis is is characterized:

a. Drooling

b. H. Influenza infections

c. Group A streptococcal infections

d. Inflammation from vocal cords to brochial lumina

D. Inflammation from vocal cords two bronchial Lumina  

The most common cause of bronchiolitis is :

a. H. influenzae

b. exposure to allergens

c. parainfluenza virus

d. respiratory syncytial virus

D. Respiratory Syncytial Virus

Most children who aspirate foreign objects:

b. Remove the offending object by coughing

c. lodged in the trachea exhibit wheezing

d. lodged in the airways exhibit Stridor

A. Exhibit quiescent intervals before symptoms appear

Staphylococcal pneumonia results in:

C. Lobar involvement

Which is true of childhood pneumonias ?

a. All pneumonias are mostly lobar

b. systemic involvement is greater in viral then in bacterial pneumonias

c. viral Pneumonias are often preceded by a "cold" 

d. all of the above are correct

C. Viral pneumonias are often preceded by a cold

Which statement about SIDS is true?

a. It commonly occurs during autumn

b. its etiology is known

c. it occurs between three and four months of age

d. it may be effectively treated

C. It occurs between three and four months of age

Cystic fibrosis is:

a. A  Multisystem disease

b. A Defect that results in the overproduction of vicous   mucus

c. A disease for which it is difficult to detect carriers through genetic testing

d. diagnosed by sweat chloride testing

e. a. b. and d. are correct

E. a. b. and d. are correct

Asthma:

a. triggers include allergens and viruses

b. of Affected individuals may be assumed to be cured if they are asymptomatic for a number of years

c. is characterized by hyper responsive  airways

d. both a. and c. are correct

e. a. b. and c. are correct

D. Both a. and c. are correct

 triggers include allergens and viruses and it is characterized by hyper responsive airways

Respiratory distress syndrome of the newborn :

a. Exhibits vasodilation of the pulmonary vascular bed

b. Develops less capillary permeability, which causes fibrin deposits

c. can be treated with nitric oxide to alleviate pulmonary hypertension

d. can be treated at birth by the administration glucocorticoids

C. Can be treated with nitric oxide to alleviate pulmonary hypertension

Asthma is:

A chronic condition

 a genetic predisposition

 and inflammatory basis with hyper responsive airways

Cystic fibrosis is :

A chronic condition

 a genetic predisposition

laryngotracheobronchitis is :

Para influenza virus

 occurs epidemically in fall and winter  

Bronchopulmonary dysplasia is :

Neonatal chronic lung disease and

 may be a consequence of prematurity

Epiglottitis is :

An acute life-threatening infection

Respiratory distress syndrome :

May result in persistent fetal circulation and may be a consequence of prematurity

Renal function tests include :

D. Both a. and b. are correct

 urinalysis, BUN, and serum creatinine

Which substance is an abnormal constitute of urine ?

a. Urea

b. glucose

c. sodium chloride

d. creatinine

B. Glucose

The presence of albumin in the urine would indicate probable damage to:

a. glomeruli

b. renal columns

c. collecting tubules

d. pyramids

A. Glomeruli

Upper urinary tract obstruction:

a. can cause hydroureter

b. increases the force of detrusor contraction

c. predisposes an individual to hypotension

d. increases post void residual volume

A. Can cause hydroureter

Renal calculi may be composed of :

a. Calcium oxalate

b. Uric acid

c. cholesterol

d. all of the above are correct

e. Both a Land b. are correct

E. Both a. and b. are correct

 calcium oxalate and uric acid

Which is a characteristic of ureteral stones located in the renal pelvis?

a. Pain radiating to the lower abdomen

b. Urgency

c. incontinence

d. pain radiating to the groin

D. Pain radiating to the groin

A common cause of both pyelonephritis and cystitis is?

a. Urinary calculi

b. Invading microorganisms, such as E. coli

c. allergy reactions

d. heavy metals

B. Invading micro organisms such as E. coli

Uremia exhibits:

a. polycythemia

b. electrolyte disorders 

c. low Plasma calcium levels

d. increased erythropoiesis

B. Electrolyte disorders

Which renal condition usually involves a history of recent infection with group A beta hemolytic streptococci?

a. Pyelonephritis

b. chronic renal failure

c. nephrosis

d. glomerulonephritis

e. calculi

D. Glomerulonephritis

The most common pathogenesis of cystitis, and infection, is acquired through /from:

a. an Ascending or exogenous route

b. a hematogenous route

c. a bladder stone obstruction 

d. pyelitis

A. an ascending or exogenous route

Nephrotic syndrome is associated with________ to plasma __________.

a. increased glomerular permeability, urea

b. decreased glomerular permeability, proteins 

c. decreased glomerular permeability, tubular filtrate

d. increased glomerular permeability, proteins

D. Increased Glomerular permeability, proteins

Causes of acute renal failure include:

a. cholecystitis

b. stones and strictures in kidneys or ureters

c. heart failure leading to poor renal perfusion

d. Both b. and c. are correct

e. a. b. and c. are correct

D. Both b. and c. are correct

 stones and strictures in kidneys or ureters

 heart failure leading to poor renal perfusion

Hypertension of nephrotic syndrome occurs because:

a. inflammation of glomeruli stimulates the secretion of  renin, which elevates blood pressure

b. systemic hypoperfusion stimulates the secretion of renin which elevates blood pressure

c. excessive angiotensin is secreted from the adrenal cortex during kidney disease 

d. localized hypoperfusion of glomeruli stimulates renin secretion, which elevates blood pressure

D. Localized hypoperfusion of glomeruli stimulates renin  secretion, which elevates blood pressure

Chronic kidney disease :

a. May result from hypertension

b. Is usually result of chronic inflammation of the kidney

c. May be treated  with dialysis or transplants

d. All of the above are correct

e. Both a. and b. are correct

D. all of the above are correct

may result from hypertension

 is usually a result of chronic inflammation of the kidney

 may be treated with dialysis or transplant

Nephrotoxins such as the antibiotics may be responsible for:

a. acute tubular necrosis

b. acute glomerulonephritis

c. pyelonephritis

d. cystitis 

A.  Acute tubular necrosis

Uremia as seen in chronic renal failure, would manifest:

a. Metabolic acidosis

b. Elevated BUN and creatinine

c. cardiovascular disturbances

d. All of the above are correct

D.   All of the above are correct

metabolic acidosis

 elevated BUN in creatinine

 cardiovascular disturbances

Hematuria in the absence of proteinuria indicates injury to the:

a. glomerulus

b. Renal tubule

c. ureter

d. renal medulla

C. Ureter

In chronic renal failure, tubulointerstitial disease leads to:

a. sodium retention

b. Sodium wasting

c. no significant changes in sodium levels

d. increased phosphate excretion

B. Sodium wasting

Frequent small voidings suggest:

a. CHT

b. prostatic hyperplasia

c. nephrotic syndrome

d. hepatic cirrhosis

B. Prostatic hyperplasia

Bacterial infection of kidney parenchyma is :

a. pyelitis

b. cystitis

c. pyelonephritis

d. pyuria

e. pyelonephrosis

C. Pyelonephritis

Which sign describes the patient in acute renal failure?

a. Elevated serum creatinine

b. Leukocytosis

c. low LN

d. fever

A. elevated serum creatinine

Lesions affecting spinal cord segments C2-S1 cause:

C. Inharmonious coordination between detrusor and urethral muscles

Epithelial proliferation and capsular space causes the condition of

Rapidly progressive Glomerulonephritis

Hypovolemia causes

Prerenal failure

Uremia causes

Pruritus

Urine formation and excretion begin by the ______month of gestation

Third

Genetically, the______________ plays an important role at all stages of kidney development

Wilms tumor gene I

During the first year of life, infants GFR is about ______________ of adult levels

30 to 50%

The primitive glomeruli and uriniferous tubules developed from the _____________

Metanephrogenic Blastema

When a child has had and then looses bladder control, is known as______________

Secondary enuresis

A__________ kidney is a small but normal functioning organ

dysplastic

____________ is a blockage were the renal pelvis joins the ureter

Ureteropelvic Junction obstruction

_____________ exhibits a urethral meatus on the ventral surface of the penis

Hypospadias

Urine seepage on to the abdominal wall from the ureter can be observed in _______________

Exstrophy of the bladder

Polycystic kidney disease is an autosomal ____________ disorder

Dominant

Bilateral renal agenesis is usually ________

Fatal

Congenital  malpositioning of the ureter or ureters into the bladder causes _______________ 

Primary vesicouretreal reflux

_____________ is responsible for most school aged children who require dialysis and kidney transplantation

Chronic Glomerulonephritis

Common childhood glomerular diseases include glomerulonephritis, hemolytic uremic syndrome, and _____________________

Nephrotic syndrome

Postreptococcal glomerulitis in children:

renal disease

b. causes hypotension

c. causes dehydration

d. Both b. and c. are correct

A. Is a postinfectious renal disease

Infants cannot concentrate urine because of:

a. shorter tubular length

b. Increased tubular length

c. increased bloodflow to the kidneys

d. Both a. and c. are correct

e. a. b. and c. are correct

D.  Both a. and c. are correct

Shorter tubular length

 increased blood flow to the kidneys

Vesicoureteral reflux causes urine to ________ up the ureters and places the young child at risk for _____________

C. retrograde, pyelonephritis

IgA  nephropathy:

a. occurs in the presence of other systemic immunologic diseases

b. Has No other immunoglobulin present

c. damages the glomerulus irreversibly

d. manifest as recurrent gross hematuria

D. manifest as recurrent gross hematuria

Organic causes of enuresis may include:

a. congenital abnormalities of the urinary tract

b. a neurologic origin

c. diabetes insipidus

d. all of the above are correct    

D. All of the above are correct

 congenital abnormalities of the urinary tract

 a neurologic origin

 diabetes insipidus

Which clinical manifestation suggest hemolytic uremic syndrome?

a. polyuria

b. Pallor and bruising

c. hypotension

d. all of the above are correct

B. pallor and bruising

Childhood urinary tract infection results from :

a. Bacteria ascending up the ureter in cystitis

b. Bacteria ascending up the urethra in pyelonephritis

c. Detrusor muscle hypo activity

d. a pathogenic strain of E. coli

D. A pathogenic strain of E. coli

Wilms tumor is characterized by:

a. hypotension

b. diagnosis in the early teens 

c. loss  or inactivation of both copies of the Wilms tumor suppressor gene 

d. transmission in an autosomal recessive fashion for inherited cases

C. Loss or inactivation of both copies of the Wilms tumor suppressor gene

Alphabetize the sequence of events in hemolytic uremic syndrome that cause anemia

a. narrowed vessels damage erythrocytes

b. the damaged cells are removed from the circulation by the spleen

c. the endothelial mining of the glomerular arterioles become swollen 

B   C   A

the damaged cells are removed from the circulation by the spleen

 the endothelial mining of the glomerular arterioles becomes swollen

  narrowed vessels damage erythrocytes

Childhood nephrotic syndrome is characterized by :

a. Having a peak incidence during the teen years

b. increased glomerular permeability to proteins

c. hypo Hpidemia

d. injured renal interstitial tissue  

B. Increased glomerular permeability to proteins