Deck 35: Alterations of Renal and Urinary Tract Function in Children

Question 1

Approximately one third of individuals with horseshoe kidneys are asymptomatic.

Answer 1

True

Question 2

The adult takes in and excretes 2000 ml/day (representing approximately 5% of the total body fluid),whereas the infant takes in and excretes 700 ml/day (representing _____ % of the total body fluid).

A) 10
B) 90
C) 190
D) 290

Answer 2

290

Question 3

Hemolytic-uremic syndrome frequently causes acute renal failure in young children.

Answer 3

True

Question 4

Which statement is false about why infants have a narrow chemical safety margin?

A) The immaturity of tubules may diminish the response to antidiuretic hormone (ADH).
B) An immature tubular transport capacity impairs the excretion of potassium.
C) An immature tubular transport capacity impairs the reabsorption of bicarbonate or buffer hydrogen with ammonia.
D) The immaturity of tubules may diminish the response to aldosterone.

Question 5

Organic causes of enuresis are the most common.

Question 6

The total electrolyte concentration in extracellular fluids is greater in the newborn than in the adult.

Question 7

Urine formation and excretion begin at:

A) birth.
B) the third month of gestation.
C) the sixth month of gestation.
D) the ninth month of gestation.

Question 8

Structural anomalies that are associated with urinary tract malformations include low-set,malformed ears;absent abdominal muscles;and imperforate anus or genital deviation.

Question 9

On examination of a male child,it is determined that the urethral meatus is located on the undersurface of the penis.This condition is called:

A) hypospadias.
B) epispadias.
C) hyperspadias.
D) chordee.

Question 10

What initiates inflammation in acute poststreptococcal glomerulonephritis (PSGN)?

A) Lysosomal enzymes
B) Endotoxins from the streptococcus
C) Immune complexes
D) Immunoglobulin E (IgE)mediated response

Question 11

Why is the excretion of urea low in infants?

A) Because medullary nephrons of infants have comparatively shorter loops at this stage of development
B) Because infants have an immature tubular transport capacity,which impairs the excretion of urea
C) Because infants have a high anabolic state and use their protein for growth
D) Because infants have dilute urine due to the immaturity of their glomeruli

Question 12

Which cells of the inflammatory process are NOT found in acute poststreptococcal glomerulonephritis (PSGN)?

A) Immunoglobulin G (IgG)
B) Immunoglobulin A (IgA)
C) Complement C₃
D) Immunoglobulin E (IgE)

Question 13

Unilateral renal agenesis is the total lack of one kidney and happens more often on the left side and in males.

Question 14

Which of the following represents the final stage in the embryonic development of the kidney?

A) Metanephros
B) Mesonephros
C) Pronephros
D) Endonephros

Question 15

Epispadias may only be found in males.

Question 16

Which statement is false about how hypospadias develops?

A) Hypospadias results from a disruption in male hormones,including testosterone.
B) Hypospadias results from a mutation of genes HP-1 (chromosome 16).
C) Hypospadias results from 5a reductase mutations.
D) Hypospadias results from hormones administered for in vitro fertilization.

Question 17

Urine formation and excretion do not begin until the eighth month of gestation.

Question 18

Chordee is a congenital defect of the genitourinary tract that results in a ventral curvature of the penis.

Question 19

Why does hypertension occur in acute poststreptococcal glomerulonephritis (PSGN)?

A) Because of the increase in capillary permeability along the glomerular vascular membrane.
B) Because of the release of endothelin-1 as a result of endothelial injury and platelet activation.
C) Because of the activation of the renin-angiotensin-aldosterone system stimulated by decreased renal perfusion.
D) Because of the stimulation of a-adrenergic nerves that cause vasoconstriction.

Question 20

The number of nephrons in the kidneys increases from birth until puberty.

Question 21

MATCHING
Match the kidney disorder with the corresponding descriptions.
IgA nephropathy causing inflammation to glomerular blood vessels

A)Hemolytic-uremic syndrome
B)Henoch-Schönlein nephritis
C)Renal dysplasia
D)Ureteropelvic junction obstruction
E)Polycystic kidney disease

Question 22

MATCHING
Match the kidney disorder with the corresponding descriptions.
Associated with functional or organic obstruction of the collecting system

A)Hemolytic-uremic syndrome
B)Henoch-Schönlein nephritis
C)Renal dysplasia
D)Ureteropelvic junction obstruction
E)Polycystic kidney disease

Question 23

Which of the following is not considered part of the nephrotic syndrome in children?

A) Proteinuria
B) Pyuria
C) Hyperlipidemia
D) Edema

Question 24

Which statement is false about the causes of enuresis?

A) Enuresis is caused by a maturational lag.
B) Enuresis may be related to nonrapid eye movement (NREM)sleep.
C) Enuresis may be a symptom of obstructive sleep apnea.
D) Enuresis may be caused by excessive antidiuretic hormone (ADH).

Question 25

What is the pathophysiologic process in hemolytic-uremic syndrome?

A) An autoimmune disorder in which immunoglobulin A (IgA)coats erythrocytes that are destroyed by the spleen and remnants are excreted through the kidneys.
B) Verotoxin from E.coli is absorbed from the intestines and damages erythrocytes and endothelial cells.
C)Endotoxins from E.coli block the erythropoietin produced by the kidneys,which reduces the number of erythrocytes produced by the bone marrow.
D)Failure of the nephron to filter urea increases the blood urea nitrogen,which binds to erythrocytes that are subsequently destroyed by the spleen.

Question 26

_____ is an anomaly often associated with Wilms' tumor.

A) Renal anaplasia
B) Aniridia (lack of an iris in the eye)
C) Anemia
D) Hypothyroidism

Question 27

MATCHING
Match the kidney disorder with the corresponding descriptions.
The most common cause of hydronephrosis in neonates

A)Hemolytic-uremic syndrome
B)Henoch-Schönlein nephritis
C)Renal dysplasia
D)Ureteropelvic junction obstruction
E)Polycystic kidney disease

Question 28

MATCHING
Match the kidney disorder with the corresponding descriptions.
Autosomal dominant inherited disorder

A)Hemolytic-uremic syndrome
B)Henoch-Schönlein nephritis
C)Renal dysplasia
D)Ureteropelvic junction obstruction
E)Polycystic kidney disease

Question 29

What causes the smoky,brown-colored urine in acute poststreptococcal glomerulonephritis (PSGN)?

A) The presence of red blood cells
B) The presence of urobilinogen
C) The slough from the collecting tubules
D) The protein that is in the urine

Question 30

What is the first indication of nephrotic syndrome in children?

A) Periorbital edema
B) Scrotal or labial edema
C) Frothy urine
D) Ascites

Question 31

MATCHING
Match the kidney disorder with the corresponding descriptions.
Fibrin rich thrombi can be found throughout the microcirculation

A)Hemolytic-uremic syndrome
B)Henoch-Schönlein nephritis
C)Renal dysplasia
D)Ureteropelvic junction obstruction
E)Polycystic kidney disease

Question 32

What is the mechanism for development of Wilms' tumor?

A) It involves tumor-suppressor genes.
B) It is an autosomal dominant inherited disorder.
C) It is an autoimmune disorder.
D) It is a congenital anomaly.

Question 33

Why does vesicoureteral reflux occur in children?

A) Because they do not ask for help in urinating in a timely manner and urine is forced up into the ureters
B) Because the submucosal segment of the ureter is short,making the antireflux mechanism inefficient
C) Because the trigone lying between the opening to the ureters and the urethra is underdeveloped
D) Because as the bladder in infants and children fill,it pulls the smooth lining of the transitional epithelium away from the ureters so that the reflux valves are ineffective

Question 34

In immunoglobulin A (IgA)nephropathy (Berger nephropathy),where are the IgA,IgM and complement proteins deposited?

A) In the juxtamedullary nephrons
B) In the glomerular endothelium
C) In the mesangium of the glomerular capillaries
D) In the parietal epithelium

Question 35

How do bacteria gain access to the urinary tract?

A) The bacteria come from systemic blood that is filtered through the kidney.
B) The bacteria travel from the lymph adjacent to the bladder and kidneys.
C) The bacteria ascend up the urethra into the bladder or up the ureters into the kidney.
D) The bacteria colonize the bladder when urine is static.