Deck 36: Alterations of Pulmonary Function in Children

Question 1

Which statement about the advances in the treatment of respiratory distress syndrome (RDS)of the newborn is incorrect?

A) Administering glucocorticoids to women in preterm labor accelerates the maturation of the fetus's lungs.
B) Administering oxygen to mothers during preterm labor increases their arterial oxygen before the birth of the fetus.
C) Treatment includes the instillation of exogenous surfactant down an endotracheal tube of infants weighing less than 1000 g.
D) Using continuous positive airway pressure (CPAP) supports the infant's respiratory function.

Answer 1

Administering oxygen to mothers during preterm labor increases their arterial oxygen before the birth of the fetus.

Question 2

Which criterion is used to confirm a diagnosis of asthma in an 8-year-old child?

A) Parental history of asthma
B) Serum testing that confirms increased immunoglobulin E (IgE) and eosinophil levels
C) Reduced expiratory flow rates confirmed by spirometry testing
D) Improvement on a trial of asthma medication

Answer 2

Reduced expiratory flow rates confirmed by spirometry testing

Question 3

Which immunoglobulin (Ig)is present in childhood asthma?

A) IgM
B) IgG
C) IgE
D) IgA

Answer 3

IgE

Question 4

Which option shows the correct sequence of events after atelectasis develops in respiratory distress syndrome of the newborn?

A) Increased pulmonary vascular resistance, atelectasis, hypoperfusion
B) Hypoxic vasoconstriction, right-to-left shunt hypoperfusion
C) Respiratory acidosis, hypoxemia, hypercapnia
D) Right-to-left shunt, hypoxic vasoconstriction, hypoperfusion

Question 5

Which statement best describes acute respiratory distress syndrome (ARDS)?

A) An obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation
B) A pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and the presence of bilateral infiltrates on chest x-ray imaging
C) A respiratory disorder involving an abnormal expression of a protein producing viscous mucus that lines the airways, pancreas, sweat ducts, and vas deferens
D) A pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency

Question 6

Which T-lymphocyte phenotype is the key determinant of childhood asthma?

A) Cluster of differentiation (CD) 4 T-helper Th1 lymphocytes
B) CD4 T-helper Th2 lymphocytes
C) CD8 cytotoxic T lymphocytes
D) Memory T lymphocytes

Question 7

Which type of croup is most common?

A) Bacterial
B) Viral
C) Fungal
D) Autoimmune

Question 8

Cystic fibrosis is caused by which process?

A) Autosomal recessive inheritance
B) Autosomal dominant inheritance
C) Infection
D) Malignancy

Question 9

Which cytokines activated in childhood asthma produce an allergic response?

A) Interleukin (IL)-1, IL-2, and interferon-alpha (IFN-a)
B) IL-8, IL-12, and tumor necrosis factor-alpha (TNF-a)
C) IL-4, IL-10, and colony-stimulating factor (CSF)
D) IL-4, IL-5, and IL-13

Question 10

Bronchiolitis tends to occur during the first years of life and is most often caused by what type of infection?

A) Respiratory syncytial virus (RSV)
B) Influenzavirus
C) Adenoviruses
D) Rhinovirus

Question 11

When considering the signs and symptoms of acute respiratory distress syndrome (ARDS),the absence of which condition is considered characteristic?

A) Progressive respiratory distress
B) Bilateral infiltrates
C) Decreased pulmonary compliance
D) Heart failure

Question 12

Which statement best describes cystic fibrosis?

A) Obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation
B) Respiratory disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray imaging
C) Pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens
D) Pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency

Question 13

Examination of the throat in a child demonstrating signs and symptoms of acute epiglottitis may contribute to which life-threatening complication?

A) Retropharyngeal abscess
B) Laryngospasms
C) Rupturing of the tonsils
D) Gagging induced aspiration

Question 14

Why is nasal congestion a serious threat to young infants?

A) Infants are obligatory nose breathers.
B) Their noses are small in diameter.
C) Infants become dehydrated when mouth breathing.
D) Their epiglottis is proportionally greater than the epiglottis of an adult's.

Question 15

What is the chief predisposing factor for respiratory distress syndrome (RDS)of the newborn?

A) Low birth weight
B) Alcohol consumption during pregnancy
C) Premature birth
D) Smoking during pregnancy

Question 16

What is the primary cause of respiratory distress syndrome (RDS)of the newborn?

A) Immature immune system
B) Small alveoli
C) Surfactant deficiency
D) Anemia

Question 17

Which statement accurately describes childhood asthma?

A) An obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation
B) A pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray imaging
C) A pulmonary disorder involving an abnormal expression of a protein, producing viscous mucus that lines the airways, pancreas, sweat ducts, and vas deferens
D) An obstructive airway disease characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency

Question 18

What is the primary problem resulting from respiratory distress syndrome (RDS)of the newborn?

A) Consolidation
B) Pulmonary edema
C) Atelectasis
D) Bronchiolar plugging

Question 19

How does chest wall compliance in an infant differ from that of an adult?

A) An adult's chest wall compliance is lower than an infant's.
B) An adult's chest wall compliance is higher than an infant's.
C) An adult's chest wall compliance is the same as an infant's.
D) An adult's chest wall compliance is dissimilar to that of an infant's.

Question 20

The risk for respiratory distress syndrome (RDS)decreases for premature infants when they are born between how many weeks of gestation?

A) 16 and 20
B) 20 and 24
C) 24 and 30
D) 30 and 36

Question 21

Children diagnosed with chronic asthma are likely to exhibit which symptoms? (Select all that apply.)

A) Nasal flaring
B) Musical expiratory wheezing
C) Clubbing of fingers and toes
D) Substernal retractions
E) Diaphoresis

Question 22

What are the abnormalities in cytokines found in children with cystic fibrosis (CF)?

A) Deficit of interleukin (IL)-1 and an excess of IL-4, IL-12, and interferon-alpha (IFN-a)
B) Deficit of IL-6 and an excess of IL-2, IL-8, and granulocyte colony-stimulating factor (G-CSF)
C) Deficit of IL-10 and an excess of IL-1, IL-8, and TNF-a
D) Deficit of IL-3 and an excess of IL-14, IL-24, and colony-stimulating factor (CSF)

Question 23

Where in the respiratory tract do the majority of foreign objects aspirated by children finally lodge?

A) Trachea
B) Left lung
C) Bronchus
D) Bronchioles

Question 24

What is the most common predisposing factor to obstructive sleep apnea in children?

A) Chronic respiratory infections
B) Adenotonsillar hypertrophy
C) Obligatory mouth breathing
D) Paradoxic breathing

Question 25

Between which months of age does sudden infant death syndrome (SIDS)most often occur?

A) 0 and 1
B) 2 and 4
C) 5 and 6
D) 6 and 7

Question 26

Match the sound of stridor with the location of the problem.
Upper trachea obstruction

A)Sonorous snoring
B)Muffled voice
C)High-pitched inspiratory sound, voice change, hoarse
D)Expiratory stridor or monophonic wheeze
E)Inspiratory wheezes

Question 27

What are the clinical manifestations of bacterial pneumonia in children? (Select all that apply.)

A) Fever with chills
B) Productive cough
C) Dyspnea
D) Respiratory alkalosis
E) Malaise

Question 28

Match the sound of stridor with the location of the problem.
Nasopharyngeal obstruction,such as adenotonsillar hypertrophy.

A)Sonorous snoring
B)Muffled voice
C)High-pitched inspiratory sound, voice change, hoarse
D)Expiratory stridor or monophonic wheeze
E)Inspiratory wheezes

Question 29

Match the sound of stridor with the location of the problem.
Laryngeal problems

A)Sonorous snoring
B)Muffled voice
C)High-pitched inspiratory sound, voice change, hoarse
D)Expiratory stridor or monophonic wheeze
E)Inspiratory wheezes

Question 30

Match the sound of stridor with the location of the problem.
Tracheal problems

A)Sonorous snoring
B)Muffled voice
C)High-pitched inspiratory sound, voice change, hoarse
D)Expiratory stridor or monophonic wheeze
E)Inspiratory wheezes

Question 31

Which statement is true regarding alveoli? (Select all that apply.)

A) The number of functioning alveoli is determined by birth.
B) The alveoli begin to increase in size starting at 8 years of age.
C) The complexity of the alveoli increases into adulthood.
D) These structures produce surfactant.
E) Capillaries are the origin of alveoli.

Question 32

Match the sound of stridor with the location of the problem.
Supralaryngeal obstructions

A)Sonorous snoring
B)Muffled voice
C)High-pitched inspiratory sound, voice change, hoarse
D)Expiratory stridor or monophonic wheeze
E)Inspiratory wheezes

Question 33

Which symptom is not a clinical manifestation of croup?

A) Rhinorrhea
B) Sore throat
C) Low-grade fever
D) Barking cough
E) Coarse rhonchi