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.

Accepted Answer

Administering oxygen to the mother is not a valid treatment of RDS.The other statements provide correct information regarding RDS.

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

Accepted Answer

Confirmation of the diagnosis of asthma relies on pulmonary function testing using spirometry,which can be accomplished only after the child is 5 to 6 years of age.Reduced expiratory flow rates that are reversible in response to an inhaled bronchodilator would be characteristic abnormalities.For younger children,an empiric trial of asthma medications is commonly initiated.The remaining options are major historical and physical factors that contribute but do not confirm the diagnosis of asthma in children.

Question 3

Which immunoglobulin (Ig)is present in childhood asthma?
A) IgM
B) IgG
C) IgE
D) IgA

Accepted Answer

Included in the long list of asthma-associated genes are those that code for increased levels of immune and inflammatory mediators (e.g.,interleukin [IL]-4,IgE,leukotrienes),nitric oxide,and transmembrane proteins in the endoplasmic reticulum.None of the other options are associated with childhood asthma.

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

Accepted Answer

Atelectasis results in a decrease in tidal volume,causing alveolar hypoventilation and hypercapnia.Hypoxia and hypercapnia cause pulmonary vasoconstriction,which increases intrapulmonary resistance and shunting.This results in hypoperfusion of the lung and a decrease in effective pulmonary blood flow.This selection is the only option that identifies the correct sequence of events.

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

Accepted Answer

ARDS is a condition that can result from either a direct or indirect pulmonary insult.It is defined as respiratory failure of acute onset characterized by severe hypoxemia that is refractory to treatment with supplemental oxygen,bilateral infiltrates on chest x-ray imaging,and no evidence of heart failure,as well as decreased pulmonary compliance.This selection is the only option that accurately describes ARDS.

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

Accepted Answer

Asthma develops because the Th₂ response (in which CD4 T-helper cells produce specific cytokines,such as interleukin [IL]-4,IL-5,and IL-13)promotes an atopic and allergic response in the airways.This selection is the only option that accurately identifies the appropriate T-lymphocyte phenotype.

Question 7

Which type of croup is most common?
A) Bacterial
B) Viral
C) Fungal
D) Autoimmune

Accepted Answer

In 85% of children with croup,a virus is the cause,most commonly parainfluenza.However,other viruses such as influenza A or respiratory syncytial virus (RSV)also can cause croup.

Question 8

Cystic fibrosis is caused by which process?
A) Autosomal recessive inheritance
B) Autosomal dominant inheritance
C) Infection
D) Malignancy

Accepted Answer

Cystic fibrosis is an autosomal recessive inherited disorder that is associated with defective epithelial ion transport.None of the other options cause cystic fibrosis.

Question 9

Which cytokines activated in childhood asthma produce an allergic response?
A) Interleukin (IL)-1, IL-2, and interferon-alpha (IFN-α)
B) IL-8, IL-12, and tumor necrosis factor-alpha (TNF-α)
C) IL-4, IL-10, and colony-stimulating factor (CSF)
D) IL-4, IL-5, and IL-13

Accepted Answer

Related to asthma,IL-4 and IL-13 are particularly important for B-cell switching to favor immunoglobulin E (IgE)production,and IL-5 is crucial for local differentiation and enhanced survival of eosinophils within the airways.This selection is the only option that accurately describes how cytokines produce a childhood asthmatic response.

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

Accepted Answer

The most common associated pathogen is RSV,but bronchiolitis may also be associated with adenovirus,rhinovirus,influenza,parainfluenza virus (PIV),and Mycoplasma pneumoniae.

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

Accepted Answer

ARDS is characterized by progressive respiratory distress,severe hypoxemia refractory to treatment with supplemental oxygen,decreased pulmonary compliance,bilateral infiltrates on chest x-ray imaging,and no evidence of 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

Accepted Answer

Cystic fibrosis is best described as a pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways,pancreas,sweat ducts,and vas deferens.This selection is the only option that accurately describes cystic fibrosis.

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

Accepted Answer

Examination of the throat may trigger laryngospasm and cause respiratory collapse.Death may occur in a few hours.This selection is the only option that accurately identifies the life-threatening complication that can result from an examination of the throat of a child who demonstrates the signs and symptoms of acute epiglottitis.

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.

Accepted Answer

Infants up to 2 to 3 months of age are obligatory nose breathers and are unable to breathe in through their mouths.Nasal congestion is therefore a serious threat to a young infant.This selection is the only option that accurately describes why nasal congestion is a serious threat to young infants.

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

Accepted Answer

RDS of the newborn,also known as hyaline membrane disease (HMD),is a major cause of morbidity and mortality in premature newborns.None of the other options are considered the chief predisposing factors for RDS.

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

Accepted Answer

RDS is primarily caused by surfactant deficiency and secondarily by a deficiency in alveolar surface area for gas exchange.None of the other options are related to the cause of RDS.

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

Accepted Answer

Asthma is an obstructive airway disease characterized by reversible airflow obstruction,bronchial hyperreactivity,and inflammation.This selection is the only option that accurately describes childhood asthma.

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

Accepted Answer

The primary problem is atelectasis,which causes significant hypoxemia and is difficult for the neonate to overcome because a significant negative inspiratory pressure is required to open the alveoli with each breath.None of the other options are considered a primary problem associated with RDS.

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.

Accepted Answer

Chest wall compliance is higher in infants than it is in adults,particularly in premature infants.

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

Accepted Answer

Surfactant is secreted into fetal airways between 30 and 36 weeks.The other options are not true regarding the timeframe when the risk for RDS decreases.

Quiz 36: Alterations of Pulmonary Function in Children

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

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

Which immunoglobulin (Ig) is present in childhood asthma?

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

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

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

Which type of croup is most common?

Cystic fibrosis is caused by which process?

Which cytokines activated in childhood asthma produce an allergic response?

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

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

Which statement best describes cystic fibrosis?

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

Why is nasal congestion a serious threat to young infants?

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

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

Which statement accurately describes childhood asthma?

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

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

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